title: Impact of Treatment Modalities on Survival of Patients With Locoregional Esophageal Squamous-Cell Carcinoma in Taiwan.
abstract: The optimal treatment modality for locoregional esophageal squamous-cell carcinoma (ESCC) is still undetermined. This study investigated the treatment modalities affecting survival of patients with ESCC in Taiwan.Data on 6202 patients who underwent treatment for locoregional esophageal squamous-cell carcinoma during 2008 to 2012 in Taiwan were collected from the Taiwan Cancer Registry. Patients were stratified by clinical stage. The major treatment approaches included definitive chemoradiotherapy, preoperative chemoradiation followed by esophagectomy, esophagectomy followed by adjuvant therapy, and esophagectomy alone. The impact of different treatment modalities on overall survival was analyzed.The majority of patients had stage III disease (n = 4091; 65.96%), followed by stage II (n = 1582, 25.51%) and stage I cancer (n = 529, 8.53%). The 3-year overall survival rates were 60.65% for patients with stage I disease, 36.21% for those with stage II cancer, and 21.39% for patients with stage III carcinoma. Surgery alone was associated with significantly better overall survival than the other treatment modalities for patients with stage I disease (P = 0.029) and was associated with significantly worse overall survival for patients with stage III cancer (P < 0.001). There was no survival risk difference among the different treatment methods for patients with clinical stage II disease.Multimodality treatment is recommended for patients with stage II-III esophageal squamous-cell carcinoma. Patients with clinical stage I disease can be treated with esophagectomy without preoperative therapy.
authors.affiliation: From the Institute of Health and Welfare Policy, National Yang-Ming University, Taipei (HSC, SCW); Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital (WHH, BYW); Institute of Medicine, Chung Shan Medical University, Taichung (JLK, BYW); Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital (JLK); Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine (PKH); Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei (CCL), Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua (CHL); Department of Respiratory Care, College of Health Sciences, Chang Jung Christian University, Tainan (CHL); School of Medicine, Kaohsiung Medical University, Kaohsiung (BYW); and Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan (BYW).
authors.forename: Hui-Shan
authors.initials: HS
authors.lastname: Chen
authors.forename: Wei-Heng
authors.initials: WH
authors.lastname: Hung
authors.forename: Jiunn-Liang
authors.initials: JL
authors.lastname: Ko
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Shiao-Chi
authors.initials: SC
authors.lastname: Wu
authors.forename: Ching-Hsiung
authors.initials: CH
authors.lastname: Lin
authors.forename: Bing-Yen
authors.initials: BY
authors.lastname: Wang
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology