Role of surgery in T4N0-3M0 esophageal cancer
Abstract Background This study aimed to investigate an unsettled issue that whether T4 esophageal cancer could benefit from surgery. Methods Patients with T4N0-3M0 esophageal cancer from 2004 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Ka...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03239-8 |
| _version_ | 1797414950401998848 |
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| author | Chen Qi Liwen Hu Chi Zhang Kang Wang Bingmei Qiu Jun Yi Yi Shen |
| author_facet | Chen Qi Liwen Hu Chi Zhang Kang Wang Bingmei Qiu Jun Yi Yi Shen |
| author_sort | Chen Qi |
| collection | DOAJ |
| description | Abstract Background This study aimed to investigate an unsettled issue that whether T4 esophageal cancer could benefit from surgery. Methods Patients with T4N0-3M0 esophageal cancer from 2004 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Kaplan–Meier method, Cox proportional hazard regression, and propensity score matching (PSM) were used to compare overall survival (OS) between the surgery and no-surgery group. Results A total of 1822 patients were analyzed. The multivariable Cox regression showed the HR (95% CI) for surgery vs. no surgery was 0.492 (0.427–0.567) (P < 0.001) in T4N0-3M0 cohort, 0.471 (0.354–0.627) (P < 0.001) in T4aN0-3M0 cohort, and 0.480 (0.335–0.689) (P < 0.001) in T4bN0-3M0 cohort. The HR (95% CI) for neoadjuvant therapy plus surgery vs. no surgery and surgery without neoadjuvant therapy vs. no surgery were 0.548 (0.461–0.650) (P < 0.001) and 0.464 (0.375–0.574) (P < 0.001), respectively. No significant OS difference was observed between neoadjuvant therapy plus surgery and surgery without neoadjuvant therapy: 0.966 (0.686–1.360) (P = 0.843). Subgroup analyses and PSM-adjusted analyses showed consistent results. Conclusion Surgery might bring OS improvement for T4N0-3M0 esophageal cancer patients, no matter in T4a disease or in T4b disease. Surgery with and without neoadjuvant therapy might both achieve better OS than no surgery. |
| first_indexed | 2024-03-09T05:41:21Z |
| format | Article |
| id | doaj.art-9b52f1b69fb14609900e1e803fac49b3 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-09T05:41:21Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-9b52f1b69fb14609900e1e803fac49b32023-12-03T12:24:58ZengBMCWorld Journal of Surgical Oncology1477-78192023-11-0121111110.1186/s12957-023-03239-8Role of surgery in T4N0-3M0 esophageal cancerChen Qi0Liwen Hu1Chi Zhang2Kang Wang3Bingmei Qiu4Jun Yi5Yi Shen6Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing UniversityAbstract Background This study aimed to investigate an unsettled issue that whether T4 esophageal cancer could benefit from surgery. Methods Patients with T4N0-3M0 esophageal cancer from 2004 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Kaplan–Meier method, Cox proportional hazard regression, and propensity score matching (PSM) were used to compare overall survival (OS) between the surgery and no-surgery group. Results A total of 1822 patients were analyzed. The multivariable Cox regression showed the HR (95% CI) for surgery vs. no surgery was 0.492 (0.427–0.567) (P < 0.001) in T4N0-3M0 cohort, 0.471 (0.354–0.627) (P < 0.001) in T4aN0-3M0 cohort, and 0.480 (0.335–0.689) (P < 0.001) in T4bN0-3M0 cohort. The HR (95% CI) for neoadjuvant therapy plus surgery vs. no surgery and surgery without neoadjuvant therapy vs. no surgery were 0.548 (0.461–0.650) (P < 0.001) and 0.464 (0.375–0.574) (P < 0.001), respectively. No significant OS difference was observed between neoadjuvant therapy plus surgery and surgery without neoadjuvant therapy: 0.966 (0.686–1.360) (P = 0.843). Subgroup analyses and PSM-adjusted analyses showed consistent results. Conclusion Surgery might bring OS improvement for T4N0-3M0 esophageal cancer patients, no matter in T4a disease or in T4b disease. Surgery with and without neoadjuvant therapy might both achieve better OS than no surgery.https://doi.org/10.1186/s12957-023-03239-8T4Esophageal cancerSurgeryPSMSEER |
| spellingShingle | Chen Qi Liwen Hu Chi Zhang Kang Wang Bingmei Qiu Jun Yi Yi Shen Role of surgery in T4N0-3M0 esophageal cancer World Journal of Surgical Oncology T4 Esophageal cancer Surgery PSM SEER |
| title | Role of surgery in T4N0-3M0 esophageal cancer |
| title_full | Role of surgery in T4N0-3M0 esophageal cancer |
| title_fullStr | Role of surgery in T4N0-3M0 esophageal cancer |
| title_full_unstemmed | Role of surgery in T4N0-3M0 esophageal cancer |
| title_short | Role of surgery in T4N0-3M0 esophageal cancer |
| title_sort | role of surgery in t4n0 3m0 esophageal cancer |
| topic | T4 Esophageal cancer Surgery PSM SEER |
| url | https://doi.org/10.1186/s12957-023-03239-8 |
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