title: Comparison between surgery and definitive chemoradiotherapy for patients with resectable esophageal squamous cell carcinoma: a propensity score analysis.
abstract: OBJECTIVE
  Our intent was to compare survival following neoadjuvant chemotherapy followed by surgery versus chemoradiotherapy (CRT) among patients with potentially resectable esophageal squamous cell carcinoma.
  
  
  METHODS
  Information about 406 consecutive esophageal cancer patients with resectable disease who underwent surgery with neoadjuvant chemotherapy consisting of cisplatin plus 5-fluorouracil or who underwent definitive CRT was reviewed. The survival outcomes were analyzed using the Kaplan-Meier method and propensity score-adjusted Cox proportional hazards models. Relevant variables were included in the propensity score model.
  
  
  RESULTS
  Overall, 206 patients planned to undergo surgery (S group) and 200 patients planned to undergo CRT (CRT group). In the unadjusted situation, progression-free survival and overall survival did not differ statistically between the groups. After matching, both survival outcomes were better in the S group compared to the CRT group. Subanalysis showed both survival outcomes were better in the S group for patients with only stage III disease. However, survival outcomes for stages I, II, and IV were not significantly different between treatment groups.
  
  
  CONCLUSIONS
  Among patients with resectable disease, survival outcomes in the S group were favored over those of the CRT group. These results indicate that different therapeutic strategies should be used for stage III esophageal cancer than for other stages.
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan. excell@hkg.odn.ne.jp.|Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan. excell@hkg.odn.ne.jp.
authors.forename: Motoo
authors.identifier: http://orcid.org/0000-0002-5967-0610
authors.initials: M
authors.lastname: Nomura
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Oze
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodaira
authors.affiliation: Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Komori
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Yukiya
authors.initials: Y
authors.lastname: Narita
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Masuishi
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kadowaki
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ura
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Andoh
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tachibana
authors.affiliation: Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Uemura
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.affiliation: Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Muro
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Chemoradiotherapy; Esophageal cancer; Neoadjuvant chemotherapy; Propensity score analysis; Surgery