Impact of the interval between neoadjuvant concurrent chemoradiotherapy and esophagectomy : a population -based propensity-score matched retrospective cohort study

Abstract

SUMMARY In Taiwan esophageal cancer is the 5th leading cause of cancer-specific mortality for the male population Neoadjuvant chemoradiotherapy followed by surgery is suggested for locally advanced esophageal cancer However the interval between neoadjuvant treatment and esophagectomy is not well studied The aim of this study was to evaluate the impact of different intervals on esophageal cancer patients’ overall survival The secondary endpoints included pathological complete response esophageal cancer mortality incidence of local or regional recurrence and postoperative mortality at 30 days and 90 days We enroll patients diagnosed with esophageal squamous cell carcinoma in 2011 and 2015 The data was retrieved from the Taiwan cancer registry database Patients received esophagectomy 4-7 weeks after neoadjuvant concurrent chemoradiotherapy were grouped as short interval and 8-12 weeks as long interval group A propensity-score-matched cohort was constructed for comparing the survival between the short and long interval groups Sensitivity analyses were also planned The primary study included 80 patients for each group No statistical significant difference was noted on the overall survival Between the two groups the secondary endpoints were not significantly different either Using different definition of the short/long intervals and different propensity-score matching for four sensitivity analysis the overall survival between the two groups was not statistically different Our study suggested that the interval within 4-12 weeks is not influential on the patients’ overall survival Surgeons and patients should choose the optimal timing based on clinical judgment Key words：esophageal cancer propensity score interval neoadjuvant

Date of Award	2020
Original language	English
Supervisor	Yu-Wen Chien (Supervisor)