Survival benefit of surgery with radiotherapy vs surgery alone to patients with T2-3N0M0 stage esophageal adenocarcinoma

// Yaqi Song 1, * , Guangzhou Tao 1 , Qing Guo 3, * , Xi Yang 2, * , Hongcheng Zhu 2,* , Wanwei Wang 1 , Xinchen Sun 2 1 Department of Radiation Oncology, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an 223300, China 2 Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China 3 Department of Oncology, Taizhou people’s hospital, Taizhou 225300, China * These authors have contributed equally to this work Correspondence to: Guangzhou Tao, e-mail: 13901409998@139.com Xinchen Sun, e-mail: sunxinchen2012@163.com Keywords: esophageal cancer, adenocarcinoma, radiotherapy, surgery, SEER program Received: August 02, 2015 Accepted: January 14, 2016 Published: February 8, 2016 ABSTRACT Background & Aims: This study is designed to analyze survival benefit of (neo-) adjuvant radiotherapy to patients with T2-3N0M0 stage esophageal adenocarcinoma (EAC). Methods: T2-3N0M0 stage EAC patients from 2004 to 2012 were searched from the Surveillance Epidemiology and End Results (SEER) data. Clinical factors including age, sex, race were summarized. Univariate, multivariate analysis, and stratified cox analysis based on different T stages were performed to explore the survival effect of (neo-)adjuvant radiotherapy to T2-3N0M0 stage EAC. Results: T2-3N0M0 stage EAC patients with surgery were more likely to be white race, T3 stage. Univariate analysis showed sex, age, and T stage were the prognostic factors of survival (P<0.05). Multivariate analysis proved (neo-)adjuvant radiotherapy can prolong survival time of T2-3N0M0 stage EAC (P<0.05). Further analysis based on different T stages showed that both neoadjuvant radiotherapy (HR 0.615; 95% CI 0.475-0.797) and adjuvant radiotherapy (HR 0.597; 95% 0.387-0.921) significantly reduced the risk of death of T3N0M0 stage EAC, but neither of which significantly reduced death risk of T2N0M0 stage EAC (P>0.05). Conclusions: sex, age are the independent prognostic factors of T2-3N0M0 EAC. Significant survival benefit of (neo-)adjuvant radiotherapy is only observed in patients with T3N0M0 stage EAC, but not in those with T2N0M0 stage.