Radiation therapy does not improve survival in patients who are upstaged after esophagectomy for clinical early-stage esophageal adenocarcinoma.

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Tác giả: Leah M Backhus, Mark F Berry, Devanish N Kamtam, Nicole Lin, Douglas Z Liou, Natalie S Lui, Joseph B Shrager

Ngôn ngữ: eng

Ký hiệu phân loại: 617.413 +Arteries

Thông tin xuất bản: Netherlands : JTCVS open , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 683719

OBJECTIVE: Radiation after esophagectomy may cause conduit dysfunction with unclear oncologic benefits. We hypothesized that adjuvant chemoradiation does not improve survival over chemotherapy alone for patients with pathologic upstaging after primary surgery for cT1-2N0M0 esophageal adenocarcinoma. METHODS: The impact of adjuvant therapy after primary surgery for cT1-2N0M0 esophageal adenocarcinoma upstaged to pT3-4 or pN+ in the National Cancer Database (2004-2019) was evaluated with logistic regression, Kaplan-Meier analysis, and Cox modeling. RESULTS: A total of 574 patients met inclusion criteria, 300 (52.3%) who received adjuvant therapy (chemotherapy alone in 117 [39.0%], radiation alone in 15 [5.0%], chemoradiation in 168 [56.0%]) and 274 (47.7%) who did not. Adjuvant therapy was associated with improved 5-year survival (46.8% vs 32.7%, CONCLUSIONS: Using radiation with chemotherapy as adjuvant therapy for patients upstaged after esophagectomy for cT1-2N0 esophageal adenocarcinoma is not associated with improved survival and should be considered only in select situations based on careful clinical evaluation.
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