Impact of preoperative radiotherapy on the survival of the esophageal cancer patients with stage Ⅱ

Cheng Rang; Song Xin; Zhao Xueke; Chen Peinan; Fan Zongmin; Hu Shoujia; Lv Shuang; Du Danfeng; Zhang Xiangyang; Lu Jianliang; Wang Ran; Zhou Fuyou; Wang Lidong

doi:10.3969/j.issn.1004-437X.2017.11.001

Abstract：Objective To evaluate the impact of preoperative radiotherapy on the survival of the esophageal cancer patients with stage Ⅱ.Methods A total of 381 esophageal cancer patients with stage Ⅱ were enrolled in this study.All the clinical information was derived from the databases of 500 000 esophageal and gastric cardiac carcinomas (1973-2014) of the Henan Key Laboratory for Esophageal Cancer Research.Histopathologically, all the patients were confirmed as stage Ⅱ.These patients were divided randomly into 2 groups: preoperative radiotherapy group with a total of 127 cases [75 males with an average diagnosed age of (58.83±8.67) years and 52 females with an average diagnosed age of (60.46±9.24) years]and surgery alone group with a total of 254 cases [145 males with an average diagnosed age of (59.23±7.94) years and 109 females with an average diagnosed age of (60.29±9.02) years].The conventional external irradiation with 6MV Linear Accelerator was applied to the preoperative radiotherapy group with a total of 40~60 Gy/4~6 weeks.The surgical treatment was followed after 2~4 weeks radiotherapy. The SPSS 21.0 statistical software was applied for all the data analysis. The survival rate was calculated based on Kaplan-Meier and Log-rank analysis model. The further analysis was performed between the two groups for the postoperative complications, the local lymph node metastasis and the positive stump of the residual cancer. Results The Kaplan-Meier and Log-rank analysis showed that the 1-, 3-and 5-year overall survival rates were 87%, 67% and 59% in preoperative radiotherapy group, and 84%, 70% and 57% in surgery alone group, respectively. There was no significant difference for the two groups (P=0.964). Moreover, a similar prevalence was observed between the two groups for the postoperative complications (17.32% vs 13.39%), the local lymph node metastasis (14.17% vs 16.93%) and the stump positive rate of residual cancer (0.78% vs 3.54%) (P>0.05).Conclusion The present study demonstrates that, comparing with surgery alone, the preoperative radiotherapy does not show any improvement in overall survival on the esophageal cancer patients with stage Ⅱ.