title: Survival benefit of surgery to patients with esophageal squamous cell carcinoma.
abstract: To assess if surgery provided survival benefit to patients with esophageal squamous cell carcinoma (SCC), we performed a retrospective review of 1230 patients who were newly diagnosed with stage T2-T4 esophageal SCC from 2007 to 2014 in our hospital. There were greater than 70% of patients with age under 65 years, and more than 85% were stage T3-T4 at the time of diagnosis. The median survival time was 1.06 year (95% CI 0.99-1.1 yrs). Survival analyses showed that survival time was significantly associated with age, T stage, clinical lymph node involvement and treatment modality (surgery versus definite chemoradiotherapy). Surgery still possessed a powerful impact on overall survival by multivariable analysis. Death risk of patients treated with curative surgery was significantly lower than those with definite chemoradiotherapy. Furthermore, for patients of stage T3N(+) and T4, surgery combined with (neo-)adjuvant treatment were significantly associated with higher survival rate than surgery alone or definite chemoradiotherapy. In conclusion, the patients who undergo surgery were significantly associated longer survival, therefore, curative resection should be considered for esophageal cancer patients who are medically fit for surgery. Moreover, combined with (neo-)adjuvant treatment is recommended for surgically resectable stage T3-T4 esophageal SCC.
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan.|Chang Gung University College of Medicine, Taiwan.
authors.forename: Miao-Fen
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Chang Gung University College of Medicine, Taiwan.|Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Ping-Tsung
authors.initials: PT
authors.lastname: Chen
authors.affiliation: Thoracic &Cardiovascular Surgery, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Lu
authors.affiliation: Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chuan-Pin
authors.initials: CP
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan.|Chang Gung University College of Medicine, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Chen
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome