Survival Analysis Of Different Treatments For Stage Ⅲ Esophageal Cancer

Objective Esophageal cancer is one of the common upper gastrointestinal malignancies in our country.In this study,the survival of patients with stage III esophageal cancer underwent neoadjuvant chemotherapy,postoperative chemotherapy and surgery alone were analyzed retrospectively by retrospective cohort study to compare the advantages and disadvantages of the three,and to provide a reference for the research and treatment of esophageal cancer in the future.Method Retrospective cohort study:the esophagus cancer patients with stage III that treated in the Department of Thoracic surgery of the First Hospital of Lanzhou University from January 1,2010 to December 31,2014 were enrolled.All the included patients were divided into three groups based on the different treatments(Neoadjuvant Chemotherapy,Postoperative Chemotherapy and Surgery alone).We collect the related data of basic information and treatment outcome of these patients.SPSS 24.0 software was used for analysis.Survival analysis was carried out using Kaplan-Meier method,and the survival curve of Kaplan-Meier was drawn.The survival rate was compared by Log-Rank(Mantel-Cox)test.And we calculate the HR value simultaneously.Results Survival analysis results shows that 127 patients were divided into Neoadjuvant Chemotherapy group(n=19),Postoperative Chemotherapy group(n=65)and Surgery alone(n=43).In the Neoadjuvant Chemotherapy group,the mean survival time was 28.89(25.09-32.70)months.In the Postoperative Chemotherapy group,the mean survival time was 27.97(25.61-30.33)months.And in the Surgery alone group,the mean survival time was 21.12(17.55-24.68)months.There is significant difference between Neoadjuvant Chemotherapy group vs.Surgery alone group and Postoperative Chemotherapy group vs.Surgery alone group respectively(χ~2=4.02,P=0.04,P<0.05andχ~2=8.99,P=0.003,P<0.05).Compared with Surgery alone group,Neoadjuvant Chemotherapy group and Postoperative Chemotherapy group could obviously improve overall survival based on Log-Rank(Mantel-Cox)test.HR=0.51(0.28-0.94)and 0.50(0.30-0.83).In addition,in the Neoadjuvant Chemotherapy group,the mean progression free survival was 25.95(21.23-30.67)months.In the Postoperative Chemotherapy group,the mean progression free survival was 26.07(23.48-28.67)months.And in the Surgery alone group,the mean progression free survival was19.58(16.08-23.08)months.Significant difference between Neoadjuvant Chemotherapy group vs.Surgery alone group and Postoperative Chemotherapy group vs.Surgery alone group respectively in progression free survival(χ~2=3.92,P=0.04,P<0.05 andχ~2=8.44,P=0.004,P<0.05).Compared with Surgery alone group,Neoadjuvant Chemotherapy group and Postoperative Chemotherapy group could improve progression free survival based on Log-Rank(Mantel-Cox)test.HR=0.52(0.29-0.94)and 0.52(0.32-0.85).Conclusion Survival analysis shows no difference in survival between Neoadjuvant Chemotherapy and Postoperative Chemotherapy.Respectively compared with surgery alone,Neoadjuvant chemotherapy and Postoperative Chemotherapy have obvious statistical difference.For patients with stage III esophageal cancer,Neoadjuvant Chemotherapy and Postoperative Chemotherapy have obvious advantages in survival and are more feasible treatment options for stage III esophageal cancer.