PV QA 1 - Poster Viewing Q&A 1
SU_9_2085 - The Value of Postoperative Radiation Therapy for 1 to 2 Pathological Lymph Nodes Metastases of Esophageal Squamous Cell Carcinoma Using Propensity Score-Matched: Analysis from Two-Center Study
Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3
The Value of Postoperative Radiation Therapy for 1 to 2 Pathological Lymph Nodes Metastases of Esophageal Squamous Cell Carcinoma Using Propensity Score-Matched: Analysis from Two-Center Study
W. Ni1, J. Q. Chen2, Z. Xiao1, S. F. Yu3, W. Zhang4, Z. Zhou5, D. Chen1, F. Qinfu1, X. Chen6, Y. Lin2, K. Zhu6, J. He7, S. Gao7, Q. Xue7, Y. Mao7, G. Cheng7, K. Sun7, X. Liu7, and D. Fang7; 1Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 2Departments of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China, 3Department of radiotherapy, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China, 4Department of Radiation oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention Therapy, Tianjin, China, 5Department of Radiation Oncology, National Cancer Center / Cancer Institute & Hospital, Chinese Academic of Medical Sciences, Peking Union Medical College, Beijing, China, 6Departments of Thoracic Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China, 7Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Purpose/Objective(s): To evaluate the effects of adjuvant radiotherapy for 1 to 2 lymph nodes metastases of thoracic esophageal squamous cell carcinoma.
Materials/Methods: The study retrospectively enrolled patients from January 1993 to December 2012 from two institutions. All patients underwent radical esophagectomy with two-field or three-field lymphadenectomy. Patients were defined esophageal squamous cell carcinoma with pathological 1 to 2 lymph nodes(LNs) positive. Propensity score-matched (PSM) analysis was conducted to mirror randomized study design and generate comparable study arms (surgery alone or postoperative radiotherapy). The survival rate was determined by the Kaplan-Meier method and analyzed using the Log-rank test.
Results: A total of 992 cases confirmed 1 to 2 LNs positive were eligible from 3811 patients. After PSM, 622 patients were reviewed. The median follow up was 80.7 months. The two groups were respectively 311 cases received surgery alone or postoperative radiotherapy. The median OS and DFS were 37.7 and 26.6 months. The 5-year overall survival (OS) was 45.0% for postoperative radiotherapy(PORT), which was significantly superior to surgery alone (31.3%, p=0.000). The 5-year DFS was 39.8% versus 24.2% between PORT and Surgery alone(p=0.000). In the subgroup analysis, for pathological stage T3-4 patients, PORT still achieved a favorable OS(41.3% versus 23.5%, p=0.000). However, for pathological stage T1-2 patients, PORT did not provide benefit OS(54.0%) compared with surgery alone(49.6%, p=0.201). The total recurrence rate was also decreasing in the PORT group compared with S alone(61.4% versus 75%, p=0.000). Especially for the local regional recurrence rate, the PORT decreased from 30.2% to 14.1%.
Conclusion: Postoperative radiotherapy could obviously improve the overall survival for pathological 1 to 2 lymph nodes positive of esophageal squamous cell carcinoma especially for stage T3-4.
Author Disclosure: W. Ni: None. J. Chen: None. W. Zhang: None. Y. Lin: None.