Zhou X, Chen H, Li S, Hua J, Zhang W, Li X, Si X, Zhang G. Treatment Options for T1 Stage Adenocarcinoma of Esophagogastric Junction: A Real-World Retrospective Cohort Study.
Cancer Control 2021;
28:10732748211063955. [PMID:
34913741 PMCID:
PMC8723737 DOI:
10.1177/10732748211063955]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background
The number of patients diagnosed with T1 stage adenocarcinoma of
esophagogastric junction (AEGJ) has been increasing. This study was
conducted to investigate the effect of different treatment options (surgery,
chemoradiation, and surgery+chemoradiation) on long-term survival in
patients with T1-stage AEGJ.
Methods
We searched the Surveillance, Epidemiology, and End Results (SEER) database
to identify the records of patients with T1-stage AEGJ between 2010 and
2018. Patient demographics and cancer parameters were compared among the
three groups. The Kaplan–Meier method and Cox proportional hazard modeling
were used to compare long-term survival.
Results
Data from 925 T1 stage AEGJ patients (surgery: n=516, surgery+chemoradiation:
n=206, chemoradiation: n=203) were collected. We found that the OS and CSS
rates of three treatment options had significant difference. Besides,
positive nodal status also showed lower OS and CSS rat. Multivariate Cox
regression analysis showed that surgery group has much lower risk of death
compared with chemoradiation group and similar risk of death compared with
surgery+chemoradiation group. Subgroup analysis suggested that in patients
with N1–N3 status had higher OS and CSS rates in surgery+chemoradiation
group.
Conclusion
Using SEER data, we identified a significant survival advantage with the use
of surgery compared to chemoradiation in patients with T1-stage AEGJ while
the long-term survival of patients after surgery+chemoradiation group was
not significantly different and low risk of death in positive nodal
status.
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