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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 5/2014

01-11-2014 | Original Article

Non-surgical treatment versus radical esophagectomy for clinical T1N0M0 esophageal carcinoma: a single-center experience

Authors: Inkeun Park, Yong-Hee Kim, Dok Hyun Yoon, Sook Ryun Park, Hyeong Ryul Kim, Jong Hoon Kim, Hwoon-Yong Jung, Gin Hyug Lee, Kyung-Ja Cho, Sung-Bae Kim

Published in: Cancer Chemotherapy and Pharmacology | Issue 5/2014

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Abstract

Purpose

The role of non-surgical treatments (NS), such as chemoradiotherapy or radiotherapy, for clinical T1N0M0 esophageal cancer (cT1N0M0 EC) has not been well delineated. The aim of this study was to evaluate and compare the feasibility and efficacy of NS and Surgical treatment (S) in cT1N0M0 EC patients.

Methods

The medical records of patients who received treatment for cT1N0M0 EC at Asan Medical Center between2003 and 2012 were retrospectively reviewed. The baseline characteristics, treatment outcomes and complications, and survival were compared.

Results

There were 264 S and 20 NS patients with respective median ages of 69.5 and 63.0. The main histologic finding was squamous cell carcinoma in both groups (97 and 100 %, respectively). The Eastern Cooperative Oncology Group performance status and Charlson comorbidity index score were poorer in the NS group. With a median follow-up of 49.0 months, 37 S patients (14 %) and 3 NS patients (15 %) exhibited recurrence. The first sites of recurrence for S and NS patients were locoregional (21 vs. 3 patients), distant (6 vs. 0), and both locoregional and distant (9 vs. 0), respectively. The median time-to-recurrence could not be calculated in either group (log-rank test P = 0.831). The estimated median overall survival was 64.4 months (95 % CI 37.2–91.6 months) in the NS group and could not be calculated in the S group (P = 0.056).

Conclusions

Non-surgical treatments can be an effective alternative to S for patients with cT1N0M0 EC unfit for radical surgery. The role of NS for early stage EC needs to be further verified with prospective randomized trials.
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Metadata
Title
Non-surgical treatment versus radical esophagectomy for clinical T1N0M0 esophageal carcinoma: a single-center experience
Authors
Inkeun Park
Yong-Hee Kim
Dok Hyun Yoon
Sook Ryun Park
Hyeong Ryul Kim
Jong Hoon Kim
Hwoon-Yong Jung
Gin Hyug Lee
Kyung-Ja Cho
Sung-Bae Kim
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 5/2014
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-014-2573-y

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