Effect Of Adjuvant Radiochemotherapy On Survival Of Patients With Lymph Node Positive Esophageal Squamous Cell Carcinoma

AimWhether postoperative adjuvant therapy can improve the survival of patients with locally advanced esophageal cancer is still controversial.This study aims to explore whether postoperative radiochemotherapy can improve the survival rate of patients.MethodsFrom January 2010 to December 2011,A total of 188 patients in The Affiliated Cancer Hospital of Zhengzhou University with esophageal squamous cell carcinoma underwent esophagectomy with lymph node positivity with.or without postoperative radiotherapy were eligible for retrospective analysis.All patients received postoperative adjuvant chemotherapy(AC group,n = 125)or chemoradiotherapy(PCRT group,n = 63).The total radiation dose was 50 Gy,which was completed in 25 cycles.The single irradiation dose was 2 Gy,5 times a week,for a total of 5 weeks.Radiotherapy usually begins 2 to 4 weeks after the last chemotherapy.Overall survival and disease-free survival were calculated using the Kaplan—Meier method with a log-rank test.Univariate and multivariate analyses of associations between clinicopathological variables and survival were analyzed using the Cox regression model.ResultsThe 5-year survival rate of the whole group was 34.7%.The 5-year survival rates of postoperative cheradiotherapy(PCRT)and postoperative chemotherapy(AC)groups were 39.7%and 28.8%,respectively(p=0.045).The median disease-free survival time was 15 months and 10 months in the two groups(p=0.034).In univariate analysis,sex,T stage,N stage,P stage,tumor differentiation,and postoperative treatment were significantly associated with overall survival.In multivariate analysis,tumor differentiation(moderately vs.poorly differentiated,p = 0.053,well vs.poorly differentiated,p ? 0.001),PCRT(p = 0.006),pathological T stage(p = 0.016),and pathological N stage(p = 0.048)remained significant independent prognostic factors for overall survival.ConclusionsCompared with AC alone,PCRT was associated with longer overall and disease-free survival for patients with lymph node-positive esophageal squamous cell carcinoma who underwent esophagectomy.