Concurrent chemoradiotherapy with or without surgery for patients with resectable esophageal cancer: An analysis of the National Cancer Data Base.

摘要: BACKGROUND Patients with resectable esophageal cancer (rEC) are managed either concurrent chemoradiotherapy followed by surgery (CRSx) or alone (cCR). To the authors' knowledge, there is insufficient evidence comparing overall survival of patients treated these 2 options. METHODS The National Cancer Data Base was queried for rEC cases diagnosed from 2003 through 2011. Patients previous cancers, cervical rEC, clinical stage T1N0 disease, metastasis were excluded. cCR defined as radiotherapy administered within 30 days chemotherapy. CRSx esophagectomy 90 days. Overall compared using Kaplan-Meier methods, propensity score matching, and extended Cox proportional hazards models. RESULTS Of 11,122 eligible patients, 8091 (72.7%) received 3031 (27.3%) CRSx. The odds receiving higher among American Joint Committee on II disease (vs III), adenocarcinoma squamous cell carcinoma), lesions lower one-third esophagus, private insurance, those living >25 miles treating facility in areas a median income greater percentage high school-educated residents. aged >70 years, female African-American ≥2 comorbidities, at community programs more likely to receive cCR. After 10-year rates found be significantly better (32.5 months [95% confidence interval (95% CI), 29.6-34.8 months] 23.8% CI, 20.0-27.9 months], respectively) (14.2 13.4-15.5 6.1% 3.9-9.0 respectively). CONCLUSIONS Data support inclusion after locally advanced rEC. 2017. © 2017 Society.