A retrospective comparison of clinical outcomes and quality of life measures between definitive chemoradiation alone and radical surgery for clinical stage II-III esophageal carcinoma

J Surg Oncol. 2009 Nov 1;100(6):435-41. doi: 10.1002/jso.21361.

Abstract

Background: This retrospective study was conducted to compare the treatment and quality of life (QOL) results between radical surgery and definitive chemoradiotherapy (CRT) for stage II-III carcinoma of the esophagus.

Methods: Between 2000 and 2009, 128 consecutive patients were selected for this study in which 72 were treated with definitive CRT and 56 with radical surgery. QOL was assessed using Functional Assessment of Cancer Therapy-Esophagus for 51 patients who were free of disease at the time of survey.

Results: With a median follow-up period of 37.8 months with 66 survivors, the 4y-DFS in the surgery group were 36% in the CRT group and 51% in the surgery group (P = 0.0028). In the CRT group, the number of cases of the advanced age, T4 stage, and stage III was significantly larger than the surgery group. QOL assessments were completed at rates of 100% in the CRT group and 88% in the surgery group. Overall E Total score had a significant difference between arms (CRT > surgery, P = 0.045).

Conclusions: CRT was inferior to surgery in survival but superior in QOL measures, although the CRT group had a larger number of patients with poorer prognostic factors.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma / mortality*
  • Carcinoma / pathology
  • Carcinoma / psychology
  • Carcinoma / therapy*
  • Chemotherapy, Adjuvant
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / psychology
  • Esophageal Neoplasms / therapy*
  • Esophagectomy
  • Female
  • Fluorouracil / therapeutic use
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Organoplatinum Compounds / administration & dosage
  • Quality of Life
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Sex Factors
  • Survival Rate

Substances

  • Organoplatinum Compounds
  • nedaplatin
  • Fluorouracil