Abstract：
BACKGROUND: In case of high risk of lymph node invasion after endoscopic resection (ER) of superficial esophageal squamous cell carcinoma (SCC), adjuvant chemoradiotherapy (CRT) can be an alternative to surgery. We assessed long-term clinical outcomes of adjuvant therapy by CRT after non-curative ER for superficial SCC.
METHODS: We performed a retrospective multicenter study. From April 1999 to April 2018, all consecutive patients who underwent ER for SCC with tumor infiltration beyond the muscularis mucosae were included.
RESULTS: A total of 137 ER were analyzed. The overall nodal or metastatic recurrence-free survival rate at 5 years was 88% and specific recurrence-free survival rates at 5 years with and without adjuvant therapy were, respectively, 97.9% and 79.1% (p = 0.011). Independent factors for nodal and/or distal metastatic recurrence were age (HR = 1.075, p = 0.031), Sm infiltration depth > 200 µm (HR = 4.129, p = 0.040), and the absence of adjuvant CRT or surgery (HR = 11.322, p = 0.029).
CONCLUSIONS: In this study, adjuvant therapy is associated with a higher recurrence-free survival rate at 5 years after non-curative ER. This result suggests this approach may be considered as an alternative to surgery in selected patients.
METHODS: We performed a retrospective multicenter study. From April 1999 to April 2018, all consecutive patients who underwent ER for SCC with tumor infiltration beyond the muscularis mucosae were included.
RESULTS: A total of 137 ER were analyzed. The overall nodal or metastatic recurrence-free survival rate at 5 years was 88% and specific recurrence-free survival rates at 5 years with and without adjuvant therapy were, respectively, 97.9% and 79.1% (p = 0.011). Independent factors for nodal and/or distal metastatic recurrence were age (HR = 1.075, p = 0.031), Sm infiltration depth > 200 µm (HR = 4.129, p = 0.040), and the absence of adjuvant CRT or surgery (HR = 11.322, p = 0.029).
CONCLUSIONS: In this study, adjuvant therapy is associated with a higher recurrence-free survival rate at 5 years after non-curative ER. This result suggests this approach may be considered as an alternative to surgery in selected patients.
摘要：
背景：对于浅表性食管鳞状细胞癌（SCC）的内镜切除术（ER）后淋巴结侵犯的高风险，辅助放化疗（CRT）可以替代手术。我们评估了非治愈性ER治疗浅表SCC后CRT辅助治疗的长期临床结果。
方法：我们进行了一项多中心回顾性研究。从1999年4月至2018年4月，包括所有因SCC而接受ER且肿瘤浸润超过粘膜肌层的患者。
结果：共分析了137例ER。5年的总淋巴结或无转移复发生存率为88％，有或没有辅助治疗的5年的无复发生存率为，分别,97.9%和79.1%(p=0.011)。淋巴结和/或远端转移复发的独立因素是年龄（HR=1.075，p=0.031），Sm入渗深度>200µm(HR=4.129,p=0.040),和没有辅助CRT或手术（HR=11.322，p=0.029）。
结论：在这项研究中，在非治愈性ER后5年,辅助治疗与较高的无复发生存率相关.该结果表明，这种方法可以被认为是某些患者手术的替代方法。
方法：我们进行了一项多中心回顾性研究。从1999年4月至2018年4月，包括所有因SCC而接受ER且肿瘤浸润超过粘膜肌层的患者。
结果：共分析了137例ER。5年的总淋巴结或无转移复发生存率为88％，有或没有辅助治疗的5年的无复发生存率为，分别,97.9%和79.1%(p=0.011)。淋巴结和/或远端转移复发的独立因素是年龄（HR=1.075，p=0.031），Sm入渗深度>200µm(HR=4.129,p=0.040),和没有辅助CRT或手术（HR=11.322，p=0.029）。
结论：在这项研究中，在非治愈性ER后5年,辅助治疗与较高的无复发生存率相关.该结果表明，这种方法可以被认为是某些患者手术的替代方法。
