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Background <p>We occasionally experience incomplete resection of esophageal cancer due to the surrounding organ invasion. The efficacy of additional treatment in these cases is unknown.</p> Methods <p>We studied 445 patients with esophageal squamous cell carcinoma who were unable to undergo curative esophagectomy due to cancer invasion to the surrounding organs at 45 esophageal centers in Japan. Survival outcomes were compared based on the additional treatment modalities.</p> Results <p>Postoperatively, 175 (40.0%) received no additional treatment, while 59 (13.5%), 153 (35.0%), and 50 (11.4%) received additional chemotherapy, chemoradiotherapy, or radiotherapy, respectively. The three-year disease progression and overall survival rates were 90.6% (95% confidence interval 87.2–93.1%) and 15.4% (95% confidence interval 12.2–19.3%), respectively. Multivariable analysis revealed that chemotherapy, chemoradiotherapy, and radiotherapy were all independently associated with reduced disease progression (hazard ratios [95% confidence intervals]: 0.57 [0.40–0.81], 0.52 [0.39–0.69], and 0.48 [0.33–0.72], respectively). Meanwhile, additional treatment with chemotherapeutic agents (chemotherapy and chemoradiotherapy) was independently associated with better overall survival (hazard ratios [95% confidence intervals]: 0.51 [0.35–0.73] and 0.59 [0.44–0.79], respectively); however, radiotherapy alone had a limited impact (hazard ratio [95% confidence interval]: 0.74 [0.50–1.10]).</p> Conclusions <p>Any additional treatment could suppress disease progression after incomplete resection, but radiotherapy alone has a limited effect. Additional systemic chemotherapeutics may increase patient survival.</p>

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Additional treatment for esophageal cancer patients with incomplete resection due to the surrounding organ invasion: a nationwide survey of 45 Japanese centers

  • 期刊论文

  • 发表日期：

    2025年9月16日

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  • Akihiko Okamura,
  • Masayuki Watanabe,
  • Jun Okui,
  • Satoru Matsuda,
  • Yoichi Hamai,
  • Naoki Takahashi,
  • Shinsuke Sato,
  • Tetsuya Abe,
  • Hirotaka Ishida,
  • Hironobu Goto,
  • Takeo Bamba,
  • Tomokazu Kakishita,
  • Eisuke Booka,
  • Hidehiko Kitagami,
  • Shirou Kuwabara,
  • Yasue Kimura,
  • Keisuke Kosumi,
  • Sohei Matsumoto,
  • Masanobu Nakajima,
  • Seiya Inoue,
  • Hiroyuki Kitagawa,
  • Susumu Shibasaki,
  • Noriaki Sadanaga,
  • Katsushi Takebayashi,
  • Toshiaki Shichinohe,
  • Hirofumi Kawakubo,
  • Yoshihiro Kakeji,
  • Koji Kono,
  • Yuko Kitagawa,
  • Hiroya Takeuchi

摘要

Background

We occasionally experience incomplete resection of esophageal cancer due to the surrounding organ invasion. The efficacy of additional treatment in these cases is unknown.

Methods

We studied 445 patients with esophageal squamous cell carcinoma who were unable to undergo curative esophagectomy due to cancer invasion to the surrounding organs at 45 esophageal centers in Japan. Survival outcomes were compared based on the additional treatment modalities.

Results

Postoperatively, 175 (40.0%) received no additional treatment, while 59 (13.5%), 153 (35.0%), and 50 (11.4%) received additional chemotherapy, chemoradiotherapy, or radiotherapy, respectively. The three-year disease progression and overall survival rates were 90.6% (95% confidence interval 87.2–93.1%) and 15.4% (95% confidence interval 12.2–19.3%), respectively. Multivariable analysis revealed that chemotherapy, chemoradiotherapy, and radiotherapy were all independently associated with reduced disease progression (hazard ratios [95% confidence intervals]: 0.57 [0.40–0.81], 0.52 [0.39–0.69], and 0.48 [0.33–0.72], respectively). Meanwhile, additional treatment with chemotherapeutic agents (chemotherapy and chemoradiotherapy) was independently associated with better overall survival (hazard ratios [95% confidence intervals]: 0.51 [0.35–0.73] and 0.59 [0.44–0.79], respectively); however, radiotherapy alone had a limited impact (hazard ratio [95% confidence interval]: 0.74 [0.50–1.10]).

Conclusions

Any additional treatment could suppress disease progression after incomplete resection, but radiotherapy alone has a limited effect. Additional systemic chemotherapeutics may increase patient survival.