■内镜治疗是早期食管癌(EC)治疗的可选策略,尤其是阶段T1a.然而,其治疗T1bEC的疗效尚未得到彻底评估.我们调查了食管切除术的疗效,内镜治疗,以及T1bN0M0EC患者的放化疗。
■监视,流行病学,和最终结果数据库(SEER)用于识别诊断为T1bN0M0EC的患者。在内窥镜治疗中比较了患者的人口统计学,食管切除术,和放化疗组。我们的研究采用Kaplan-Meier分析和Cox回归模型来评估患者的预后和长期生存率。比较接受内镜治疗或食管切除术的EC患者的总生存率(OS)和癌症特异性生存率(CSS)。采用倾向得分匹配(PSM)。
■共确定了820例诊断为T1bN0M0EC的患者。接受内镜治疗的患者数量,食管切除术,放化疗分别为173、556和91。接受内镜治疗和食管切除术的患者的OS和CSS比接受放化疗的患者长得多。接受食管切除术治疗的患者比内镜治疗的患者有更长的OS,但两组之间的CSS没有差异。PSM在T1bN0M0患者中产生了153对患者,证明食管切除术组和内镜治疗组均表现出相当的OS和CSS率.
■在T1bN0M0EC患者中,内镜治疗和食管切除术与放化疗相比具有显著的生存优势。相比之下,在PSM之后,在T1bN0M0期EC患者中,内镜治疗或食管切除术后OS和CSS无差异.这些结果表明,在诊断为T1bN0M0EC的患者中,内镜治疗可能是食管切除术的可行替代方法。
UNASSIGNED: Endoscopic therapy is an optional strategy for the treatment of esophageal cancer (EC) under an early stage, especially stage T1a. However, its efficacy in the treatment of T1b EC has not been thoroughly assessed. We investigated the efficacy of esophagectomy, endoscopic therapy, as well as chemoradiotherapy in patients with T1bN0M0 EC.
UNASSIGNED: The Surveillance, Epidemiology, and End Results database (SEER) was employed to identify patients diagnosed with T1bN0M0 EC. Patient demographics were compared among the endoscopic therapy, esophagectomy, and chemoradiotherapy groups. Our study employed Kaplan-Meier analysis and Cox regression model to evaluate patient outcomes and long-term survival rates. The overall survival (OS) and cancer-specific survival (CSS) rates were compared among patients with EC who underwent endoscopic therapy or esophagectomy, employing propensity score matching (PSM).
UNASSIGNED: A total of 820 patients diagnosed with T1bN0M0 EC were identified. The number of patients who received endoscopic therapy, esophagectomy, and chemoradiotherapy was 173, 556, and 91, respectively. Patients subjected to endoscopic therapy and esophagectomy had greatly longer OS and CSS than those who underwent chemoradiotherapy. Patients treated with esophagectomy had longer OS than endoscopic therapy patients, but there were no differences in CSS between the two groups. PSM generated 153 patient pairs among T1bN0M0 patients, demonstrating that both the esophagectomy and endoscopic therapy groups exhibited comparable OS and CSS rates.
UNASSIGNED: Endoscopic therapy and esophagectomy were associated with a significant survival advantage compared with chemoradiotherapy in patients with T1bN0M0 EC. In contrast, after PSM, among the EC patients with stage T1bN0M0, OS and CSS did not differ after endoscopic therapy or esophagectomy. These results indicate that endoscopic therapy could be a viable alternative to esophagectomy in patients diagnosed with T1bN0M0 EC.