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논문 기본 정보

자료유형
학술저널
저자정보
유제상 (고신대학교) 김종훈 (울산대학교) 김성배 (서울아산병원) 박숙련 (울산대학교) 김영희 (울산대학교) 김형렬 (울산대학교) 이현주 (서울아산병원) 송호준 (울산대학교) 송계진 (울산대학교) 장정윤 (서울아산병원) 조윤영 (울산대학교) 유예진 (울산대학교)
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제54권 제4호
발행연도
2022.10
수록면
1,148 - 1,156 (9page)
DOI
10.4143/crt.2021.885

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PurposeThis study aimed to evaluate the long-term effect of esophagectomy in patients with esophageal squamous cell carcinoma (ESCC) by comparing the chemoradiotherapy (CRT)-only group and the trimodality treatment (TMT) group who received concurrent CRT followed by surgery.Materials and MethodsWe included 412 operable ESCC patients treated with TMT or CRT between January 2005 and December 2015. The oncological outcomes of the two groups were compared using a weighted Cox proportional-hazards model with inverse probability of treatment weighting (IPTW).ResultsThe median survival time was 64 and 32 months in the TMT (n=270) and CRT (n=142) groups, respectively (p < 0.001). After IPTW, the median overall survival (OS) remained significantly higher in the TMT group than in the CRT group (61 months vs. 32 months, p=0.016). Moreover, the TMT group showed a better local recurrence-free rate (LRFR, p < 0.001) and distant metastasis-free rate (p=0.007). In the subgroup of patients with clinical complete response (cCR), the OS was not significantly different between the two groups, both before and after IPTW adjustment (p=0.35 and p=0.93). However, among non-cCR patients, the OS was significantly higher in the TMT group (64% vs. 45%, p < 0.001). ConclusionIn patients with locally advanced ESCC, TMT was superior to CRT in terms of OS and LRFR. Such difference was more prominent in the non-cCR subgroup. In patients who achieved cCR, esophagectomy was effective in improving LRFR but not OS, suggesting that esophagectomy may be omitted in complete responders.

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