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World Journal of Surgical Oncology

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Open Access 01-12-2018 | Research

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

Authors: Ming-Wei Ma, Xian-Shu Gao, Xiao-Bin Gu, Mu Xie, Ming Cui, Min Zhang, Ling Liu, Huan Yin, Long-Qi Chen

Published in: World Journal of Surgical Oncology | Issue 1/2018

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.

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Title: The role of definitive chemoradiotherapy versus surgery as initial treatments for potentially resectable esophageal carcinoma
Authors: Ming-Wei Ma
Xian-Shu Gao
Xiao-Bin Gu
Mu Xie
Ming Cui
Min Zhang
Ling Liu
Huan Yin
Long-Qi Chen
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-018-1470-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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