title: Postoperative chemoradiotherapy improves survival in patients with stage II-III esophageal squamous cell carcinoma: An analysis of clinical outcomes.
abstract: BACKGROUND
  We compared the efficacy of postoperative chemoradiation (POCRT) and surgery alone (SA) in patients with stage II-III esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  We analyzed the records of 265 patients with stage II-III ESCC who had undergone transthoracic esophagectomy and lymphadenectomy; 105 patients received POCRT, while 160 had SA.
  
  
  RESULTS
  The median disease-free survival (DFS) of the whole cohort was 22 months (95% confidence interval [CI], 19.2-24.8), while the median overall survival (OS) was 29 months (95% CI 25.5-32.5). The median DFS of the SA group was 21 months (95% CI 17.9-24.0), while that of the POCRT group was 29 months (95% CI 18.8-31.2; P = 0.048). Consistently, patients in the POCRT group had significantly longer median OS than patients in the SA group (34 vs. 26 months, respectively). Subgroup analysis showed that in patients with positive lymph nodes, pathological stage III, T3-4 stage, and poorly differentiated carcinoma, POCRT was apparently more effective than SA at improving OS and decreasing the rates of local recurrence and distant metastasis. Multivariate analysis demonstrated that lymph node involvement and treatment with POCRT were independent prognostic factors.
  
  
  CONCLUSIONS
  Compared with SA, POCRT may be more effective in improving OS and decreasing the rates of local recurrence and distant metastasis, particularly in stage III or positive lymph node stage II-III ESCC patients.
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Bingwen
authors.initials: B
authors.lastname: Zou
authors.affiliation: Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Pang
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Meijuan
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ren
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Youlin
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: You
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Medical School, Sichuan University, Chengdu, China.
authors.forename: Longqi
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, China. pengfwork@126.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Esophageal cancer; postoperative chemotherapy; postoperative radiotherapy; squamous cell carcinoma; surgery