2268 - Definitive Chemoradiotherapy vs. Esophagectomy In Patients with Clinical T1N0M0 Esophageal Squamous Cell Carcinoma: A Multi-Center, Retrospective Study from China
Presenter(s)
G. Xiang1, and L. Zhao2; 1Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, xi an, shan xi, China, 2Department of Radiation Oncology, First Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
Purpose/Objective(s): Definitive chemoradiotherapy (dCRT) has been regarded as an alternative therapy to esophagectomy for esophageal cancer, because of its good survival rate and mild toxicity. However, no comparative studies of two treatments have been reported in patients with clinical T1N0M0 esophageal squamous cell carcinoma (ESCC) based on multi-center data in China. This study aimed to determine the equivalence between dCRT and esophagectomy in clinical T1N0M0 ESCC.
Materials/Methods: Clinical T1N0M0 ESCC patients between 2010 and 2024 from eight centers were eligible for enrollment in this retrospective study of esophagectomy versus dCRT. The overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared
Results: Among 374 patients with cT1N0M0 ESCC, 300 underwent esophagectomy and 74 underwent dCRT. The median follow-up duration was 43.3(IQR: 23.3-76.9) and 90.6 (IQR: 49.2-104.3) in the dCRT and esophagectomy groups, respectively. 5-year OS was 83.1% and 85.3% in the dCRT and esophagectomy groups (p = 0.135). Moreover, 5-year PFS, 5-year LRFS, and DMFS were not significantly different between dCRT and esophagectomy groups (5-year PFS: 78.9% vs. 82.5%, p = 0.300; 5-year LRFS: 82.2% vs. 85.7%, p = 0.276; 5-year DMFS: 88.9% vs. 84.2%, p = 0.757).
Conclusion: The overall survival rate of patients with cT1N0M0 ESCC treated with dCRT was comparable to that in those treated with esophagectomy. dCRT seems to be as one of the standard treatment options in patients with cT1N0M0 ESCC.