- Neoadjuvant chemoradiation therapy (NCRT) is associated with better survival than upfront esophagectomy (UE) in stage 3 esophageal squamous cell carcinoma (ESCC), but both are equally effective in stage 2 disease.
Why this matters
- The study was used with the 8th edition of the American Joint Committee on Cancer Tumor-Node-Metastasis (TNM) staging system.
- Previous studies of NCRT vs esophagectomy led to mixed results, but were conducted before the advent of new TNM guidelines.
- Retrospective study of the Taiwan Cancer Registry database (n=2503).
- Funding: None disclosed.
- Stage 2:
- Median survival: 27.8 months with UE, 32.7 months with NCRT.
- Median 3-year survival rate: 39.2% with UE vs 49.8% with NCRT (P=.508).
- Power analysis to account for the small sample size, based on a sample size of 300, confirmed no statistically significant effect.
- Stage 3:
- After propensity score matching (357 pairs), median survival was 17.9 months with UE vs 24.0 months with NCRT (P<.001>
- Median 3-year survival rate: 28.2% with UE vs 41.8% with NCRT (P<.001>
- Retrospective design.