The role of definitive chemoradiotherapy versus surgery as initial treatments for potentially resectable esophageal carcinoma.

ABSTRACT: BACKGROUND:We performed a meta-analysis to compare the efficacy of definitive chemoradiotherapy (dCRT) and esophagectomy as initial treatments for potentially resectable esophageal cancer. METHODS:To assess both strategies, the combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Thirteen studies (N?=?2071; dCRT?=?869 and surgery?=?1202) were included. In all, 90.39% of the patients were diagnosed with esophageal squamous cell carcinoma (ESCC). RESULTS:The 2-year (OR?=?1.199, 95% CI 0.922-1.560; P?=?0.177) and 5-year overall survival (OS) rates (OR?=?0.947, 95% CI 0.628-1.429; P?=?0.796) were not significantly different. No significant differences were identified in the 2-year OS among patients with stage I disease (OR?=?1.397, 95% CI 0.740-2.638; P?=?0.303) or stage II-III (OR?=?0.418, 95% CI 0.022-7.833; P?=?0.560). Patients with lymph node metastases tended to have a better 5-year OS when treated with dCRT than with surgery (OR?=?0.226, 95% CI 0.044-1.169; P?=?0.076); however, the difference between the two methods was not significant. Western patients who received dCRT had poorer prognoses than patients who underwent surgery (OR?=?1.522, 95% CI 1.035-2.238; P?=?0.033). dCRT and surgery led to similar 5-year progression-free survival rates (OR?=?1.06, 95% CI 0.79-1.42; P?=?0.70). CONCLUSIONS:dCRT and surgery are equally effective as initial treatments for potentially resectable esophageal cancer. These results apply primarily to Asian populations as they have an increased incidence of ESCC.

SUBMITTER: Ma MW 

PROVIDER: S-EPMC6097217 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature