Clinical Outcome of Conversion Surgery for Stage IV Esophageal Cancer Following Chemoradiation.
Journal
Biomedicines
Journal Volume
13
Journal Issue
3
Start Page
論文號碼 745
ISSN
2227-9059
Date Issued
2025-03-18
Author(s)
Wang, Hu-Lin Christina
Abstract
We aimed to identify the impact of conversion surgery to survival in patients with stage IV esophageal cancer who have a stabilized disease and good treatment response before surgery. This retrospective study included patients with esophageal cancer M1 disease treated at a tertiary medical center from April 2002 to June 2021. For patients with a good clinical response to chemoradiation and well-controlled metastatic lesions, esophagectomy and lymphadenectomy were performed. A propensity score-matching (PSM) study with a 1:2 ratio and based on patient age, tumor stage, and metastasis status was conducted for verifying the results. We enrolled 162 patients, including 124 treated with concurrent chemoradiation therapy (CCRT) alone and 38 treated with CCRT followed by esophagectomy. A total of 114 patients were analyzed using PSM, including 76 patients treated with CCRT alone and 38 patients treated with CCRT and surgery. The 3- and 5-year OS was 24.6% vs. 2.8% and 12.3% vs. 1.4% ( = 0.006), and PSM was 24.6% vs. 4.6% and 12.3% vs. 2.3% ( = 0.033) for those with or without esophagectomy, respectively. Multivariate analysis revealed surgery with esophagectomy as an independent prognostic factor for OS with odd ratios (95% confidence interval [CI]) of 1.91 (1.23-2.95) ( = 0.004). Surgical resection following CCRT holds a potential survival benefit for the patients with a favorable response to CCRT for patients with stage IV esophageal cancer.
Subjects
esophageal cancer
metastatic
surgery
SDGs
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Type
journal article