PMID- 18538500
OWN - NLM
STAT- MEDLINE
DCOM- 20090202
LR  - 20220310
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 73
IP  - 2
DP  - 2009 Feb 1
TI  - Survival effect of neoadjuvant radiotherapy before esophagectomy for patients 
      with esophageal cancer: a surveillance, epidemiology, and end-results study.
PG  - 449-55
LID - 10.1016/j.ijrobp.2008.04.022 [doi]
AB  - PURPOSE: The role of neoadjuvant radiotherapy (NeoRT) before definitive surgery 
      for esophageal cancer remains controversial. This study used a large 
      population-based database to assess the effect of NeoRT on survival for patients 
      treated with definitive surgery. METHODS AND MATERIALS: The overall survival (OS) 
      and cause-specific survival for patients with Stage T2-T4, any N, M0 (cT2-T4M0) 
      esophageal cancer who had undergone definitive surgery between 1998 and 2004 were 
      analyzed by querying the Surveillance, Epidemiology, and End-Results database. 
      Kaplan-Meier survival curves were generated and univariate comparisons were made 
      using the log-rank test. Cox proportional hazards survival regression 
      multivariate analysis was performed with NeoRT, T stage (T2 vs. T3-T4), 
      pathologic nodal status (pN0 vs. pN1), number of nodes dissected (>10 vs. </=10), 
      histologic type (adenocarcinoma vs. squamous cell carcinoma), age (<65 vs. >/=65 
      years), and gender as covariates. RESULTS: A total of 1,033 patients were 
      identified. Of these, 441 patients received NeoRT and 592 underwent esophagectomy 
      alone; 77% were men, 67% had adenocarcinoma, and 72% had Stage T3-T4 disease. The 
      median OS and cause-specific survival were both significantly greater for 
      patients who received NeoRT compared with esophagectomy alone (27 vs. 18 months 
      and 35 vs. 21 months, respectively, p <0.0001). The 3-year OS rate was also 
      significantly greater in the NeoRT group (43% vs. 30%). On multivariate analysis, 
      NeoRT, age <65 years, adenocarcinoma histologic type, female gender, pN0 status, 
      >10 nodes dissected, and Stage T2 disease were all independently correlated with 
      increased OS. CONCLUSION: These results support the use of NeoRT for patients 
      with esophageal cancer. Prospective studies are needed to confirm these results.
FAU - Schwer, Amanda L
AU  - Schwer AL
AD  - Department of Radiation Oncology, University of Colorado Health Sciences Center, 
      Aurora, Colorado, USA.
FAU - Ballonoff, Ari
AU  - Ballonoff A
FAU - McCammon, Robert
AU  - McCammon R
FAU - Rusthoven, Kyle
AU  - Rusthoven K
FAU - D'Agostino, Ralph B Jr
AU  - D'Agostino RB Jr
FAU - Schefter, Tracey E
AU  - Schefter TE
LA  - eng
PT  - Journal Article
DEP - 20080604
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - *Adenocarcinoma/mortality/pathology/radiotherapy/surgery
MH  - Aged
MH  - Analysis of Variance
MH  - *Carcinoma, Squamous Cell/mortality/pathology/radiotherapy/surgery
MH  - *Esophageal Neoplasms/mortality/pathology/radiotherapy/surgery
MH  - *Esophagectomy/mortality
MH  - Female
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - *Neoadjuvant Therapy/mortality
MH  - Proportional Hazards Models
MH  - Radiotherapy, Adjuvant/mortality
MH  - SEER Program
MH  - Survival Analysis
EDAT- 2008/06/10 09:00
MHDA- 2009/02/03 09:00
CRDT- 2008/06/10 09:00
PHST- 2008/02/15 00:00 [received]
PHST- 2008/04/21 00:00 [revised]
PHST- 2008/04/21 00:00 [accepted]
PHST- 2008/06/10 09:00 [pubmed]
PHST- 2009/02/03 09:00 [medline]
PHST- 2008/06/10 09:00 [entrez]
AID - S0360-3016(08)00752-9 [pii]
AID - 10.1016/j.ijrobp.2008.04.022 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):449-55. doi: 
      10.1016/j.ijrobp.2008.04.022. Epub 2008 Jun 4.