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Surgery versus radiotherapy for limited-stage small cell esophageal carcinoma: a multicenter, retrospective, cohort study in China (ChiSCEC)

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收录情况： ◇ SCIE

作者：
Zhu Jie[1] * ; Wang Yi[1] * ; Sun Hongfu[2,3] * ; Zhang Yaowen[4] ; Zhang Wencheng[5] ; Shen Wenbin[6] ; Yang Ning[7] ; Tan Bingxu[8] ; Su Xiujun[9] ; Li Lei[10] ; Dong Wei[11] ; Ma Jie[12] ; Zhang Jian[13] ; Zhao Lina[14] ; Sun Daqing[15] ; Yang Pei[16,17] ; Peng Lin[18] ; Li Baosheng[2,3] ; Huang Wei[2,3,*2] ; Wang Qifeng[1,*1] ; Liao Zhongxing[19] ;
机构： [1]Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China. [2]Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China. [3]Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, China. [4]Department 6 of Radiotherapy, Anyang Cancer Hospital, The Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang, Henan Province, China. [5]Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China. [6]Department of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China. [7]Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China. [8]Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China. [9]Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China. [10]Binzhou Medical University Hospital, Binzhou, Shandong Province, China. [11]Yantai Yuhuangding Hospital, Yantai, Shandong Province, China. [12]Jining First People’s Hospital, Jining, Shandong Province, China. [13]Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China. [14]Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, Xi’an, Shanxi Province, China. [15]Weifang People’s Hospital, Weifang, Shandong Province, China. [16]Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, the Affiliate Hospital of Xiangya Medical School, Central South University, Changsha, Hunan Province, China. [17]The National Clinical Research Center for Geriatric Disorders of Xiangya Hospital Affiliated to Central South University, Changsha, Hunan Province, China. [18]Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China. [19]Department of Thoracic Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
出处：
DOI： 10.1097/JS9.0000000000000912
ISSN：

关键词： limited-stage small cell esophageal carcinoma chemotherapy radiotherapy surgery

摘要：
There is no standard management for small cell esophageal carcinoma (SCEC). The purpose of this multicenter, retrospective study (ChiSCER) was to investigate the treatment, outcomes, and risk factors impacting on survival endpoints in patients with limited-stage SCEC (LS-SCEC).Consecutive patients with LS-SCEC from 14 institutions between 2000 to 2020 in China were enrolled. Survival curves were constructed using the Kaplan-Meier method and compared by log-rank test. Univariate and multivariate Cox regression models and propensity score matching (PSM) analysis were adopted in prognostic analysis. Results were reported as hazard ratio (HR), 95% confidence interval (CI), and P value. Statistical significance was set as P value<0.05 in a two-tailed test.Among 458 LS-SCEC patients, the median age was 63 (interquartile range [IQR], 57-68) years, 318 (69%) were males. Eighty-four (18%), 167 (36%), and 207 (45%) patients received chemotherapy (CT) alone, CT plus definitive radiotherapy (CT+RT), and CT plus radical surgery (CT+S), respectively. With a median follow-up time of 58.7 (95% CI, 48.9-68.6) months, the median OS and 3-year OS rate for all patients 24.3 (95% CI, 21.6-27) months and 37.3% (95% CI, 32.8%-42.5%), respectively. Multivariate analysis indicated that treatment modes, Karnofsky performance status (KPS), TNM stage, and CT cycle were independent prognostic factors for overall survival (OS) (P<0.05). Compared with CT alone, patients treated with CT+RT (HR, 0.57, 95% CI, 0.41-0.8, P=0.001) or CT+S (HR, 0.59, 95% CI, 0.42-0.82, P=0.002) had an improved OS, with no significant survival differences between CT+S and CT+RT groups after multivariate and PSM analyses (P>0.05). Subgroup analysis indicated that compared with CT+RT, patients with tumor location at lower 1/3 (HR, 0.59, 95% CI, 0.37-0.93, P=0.03) or tumor length>5 cm (HR 0.52, 95% CI, 0.3-0.9, P=0.02) could obtain significant OS benefit from CT+S. Patients with tumor location at middle 1/3 (HR 1.55, 95% CI, 1.03-2.36, P=0.04) or tumor length≤5 cm (HR 1.49, 95% CI, 1.02-2.17, P=0.04) favored CT+RT. Distant metastasis accounted for 73.7% of all treatment failures after multidisciplinary treatments.Surgery and RT were equally effective local therapies for patients with LS-SCEC. The personalized decision of local therapy should be made after comprehensive considerations on tumor location, length, comorbidities, and organ preservation.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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出版当年[2024]版：
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最新[2023]版：
大类 | 2 区 医学
小类 | 2 区 外科
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最新[2023]版：
Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

第一作者：
第一作者机构： [1]Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China. [2]Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China. [3]Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, China. [*1]Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China. No. 55 South Renmin Ave, Fourth Section, Wuhou District, 610041 Chengdu, Sichuan Province, China. [*2]Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China. No. 55 South Renmin Ave, Fourth Section, Wuhou District, 610041 Chengdu, Sichuan Province, China. [*3]Shandong Cancer Hospital Affiliated to Shandong University, 250117 Jinan, Shandong Province, China.
推荐引用方式(GB/T 7714)：
Zhu Jie,Wang Yi,Sun Hongfu,et al.Surgery versus radiotherapy for limited-stage small cell esophageal carcinoma: a multicenter, retrospective, cohort study in China (ChiSCEC)[J].INTERNATIONAL JOURNAL OF SURGERY.2024,110(2):956-964.doi:10.1097/JS9.0000000000000912.
APA：
Zhu Jie,Wang Yi,Sun Hongfu,Zhang Yaowen,Zhang Wencheng...&Liao Zhongxing.(2024).Surgery versus radiotherapy for limited-stage small cell esophageal carcinoma: a multicenter, retrospective, cohort study in China (ChiSCEC).INTERNATIONAL JOURNAL OF SURGERY,110,(2)
MLA：
Zhu Jie,et al."Surgery versus radiotherapy for limited-stage small cell esophageal carcinoma: a multicenter, retrospective, cohort study in China (ChiSCEC)".INTERNATIONAL JOURNAL OF SURGERY 110..2(2024):956-964

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