Impact of postoperative radiation after esophagectomy for esophageal cancer. 2010

David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA. david.schreiber@downstate.edu

BACKGROUND Though postoperative radiation for esophageal cancer is offered in selected cases, there is conflicting evidence as to whether it improves overall survival (OS). We performed a retrospective analysis using the Surveillance Epidemiology and End Results database to analyze the impact of adjuvant radiation in a large cohort of patients. METHODS From 1998 to 2005, patients diagnosed with stage T3-4N0M0 or T1-4N1M0 esophageal adenocarcinoma (AC) or squamous cell carcinoma (SCC) who were definitively treated with esophagectomy, with or without postoperative radiation, were selected. Kaplan-Meier and Cox regression analysis were used to compare OS and disease-specific survival (DSS). RESULTS A total of 1046 patients met the selection criteria: 683 (65.3%) received surgery alone and 363 (34.7%) received postoperative radiation. For American Joint Committee on Cancer stage III esophageal carcinoma (T3N1M0 or T4N0-1M0), there was significant improvement in median and 3-year OS (p < 0.001) and DSS (p < 0.001), respectively. This benefit was present for both SCC and AC. However, for American Joint Committee on Cancer stages IIA and IIB disease there was no significant differences in OS or DSS. Multivariate analysis revealed that postoperative radiation was the most significant predictor for improved OS (hazard ratio 0.70, 95% confidence interval 0.59-0.83, p < 0.001). CONCLUSIONS This large population-based review supports the use of postoperative radiation for stage III SCC and AC of the esophagus. Given the retrospective nature of this study, until appropriately powered randomized trials confirm these results, caution should be used before broadly applying these findings in clinical practice.

UI MeSH Term Description Entries
D008297 Male Males
D009361 Neoplasm Invasiveness Ability of neoplasms to infiltrate and actively destroy surrounding tissue. Invasiveness, Neoplasm,Neoplasm Invasion,Invasion, Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D004938 Esophageal Neoplasms Tumors or cancer of the ESOPHAGUS. Cancer of Esophagus,Esophageal Cancer,Cancer of the Esophagus,Esophagus Cancer,Esophagus Neoplasm,Neoplasms, Esophageal,Cancer, Esophageal,Cancer, Esophagus,Cancers, Esophageal,Cancers, Esophagus,Esophageal Cancers,Esophageal Neoplasm,Esophagus Cancers,Esophagus Neoplasms,Neoplasm, Esophageal,Neoplasm, Esophagus,Neoplasms, Esophagus
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D015996 Survival Rate The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. Cumulative Survival Rate,Mean Survival Time,Cumulative Survival Rates,Mean Survival Times,Rate, Cumulative Survival,Rate, Survival,Rates, Cumulative Survival,Rates, Survival,Survival Rate, Cumulative,Survival Rates,Survival Rates, Cumulative,Survival Time, Mean,Survival Times, Mean,Time, Mean Survival,Times, Mean Survival

Related Publications

David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
August 2015, Medicine,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
June 2017, Annals of surgery,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
January 2020, Oncology,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
June 2022, Journal of clinical medicine,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
November 2011, Gan to kagaku ryoho. Cancer & chemotherapy,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
September 2021, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
September 2020, Journal of thoracic disease,
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
May 2013, Radiation oncology (London, England),
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
January 2020, In vivo (Athens, Greece),
David Schreiber, and Justin Rineer, and Dan Vongtama, and Angela Wortham, and Peter Han, and David Schwartz, and Kwang Choi, and Marvin Rotman
May 2016, World journal of surgery,
Copied contents to your clipboard!