| Analysis of the long-term efficacy of surgical treatment and endoscopic resection for superficial esophageal squamous cell carcinoma based on the SEER database |
| Received:August 10, 2021 Revised:December 15, 2021 Click here to download the full text |
| Citation of this paper:LIU Xin-yang,HE Meng-jiang,CHEN Bai-sheng,LI Quan-li,ZHOU Ping-hong,CHEN Wei-feng.Analysis of the long-term efficacy of surgical treatment and endoscopic resection for superficial esophageal squamous cell carcinoma based on the SEER database[J].Chinese Journal of Clinical Medicine,2022,29(1):42-46 |
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| Author Name | Affiliation | E-mail | | LIU Xin-yang | Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | HE Meng-jiang | Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | CHEN Bai-sheng | Endoscopy Center, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China | | | LI Quan-li | Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | ZHOU Ping-hong | Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | CHEN Wei-feng | Endoscopy Center, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China | chen.weifeng@zs-hospital.sh.cn |
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| Abstract:Objective To analyze the long-term efficiency of endoscopic treatment and surgical resection in patients with Tis and T1 esophageal squamous cell carcinoma based on SEER database, and to provide evidence for early treatment of esophageal cancer. Methods The newly diagnosed and pathologically confirmed esophageal squamous cell carcinoma cases with complete T and N staging information, without metastasis, with complete prognosis, follow-up, and treatment information of primary site originated from SEER database of the United States were acquired from 2004 to 2012. The main outcome was esophageal cancer specific mortality. Cox regression was used in factor analyses of esophageal cancer specific mortality. Results A total of 337 patients were included, among whom, 158 (46.88%) underwent surgery, 165 (48.96%) underwent local endoscopic resection (with pathological specimen), and 14 (4.15%) underwent local endoscopic destruction (without pathological specimen). 158 patients in surgery group and 165 patients in endoscopic resection group were included in survival analysis, with a follow-up time of 2-105 months and a median follow-up time of 32 months. Median survival time of patients in the surgery and endoscopic resection groups was not reached. Kaplan-Meier survival curves indicated that the esophageal cancer specific mortality were 4.24% (7/165) and 22.78% (36/158) in endoscopic resection and surgery groups,respectively. Univariate Cox regression revealed that the hazard ratio (HR) endoscopic resection was 0.21 compared to surgery (95%CI 0.09-0.46, P<0.001), and multivariate Cox regression showed that endoscopic resection was independently protective factor for patients freed from the esophageal cancer specific mortality (HR=0.34, 95%CI 0.14-0.83, P=0.017). After patients with lymph node involvement, follow-up of shorter than 6 months, or stage Tis were excluded, endoscopic resection was also independently protective factor of patients (P<0.05). Conclusion For the patients with Tis and T1 esophageal squamous cell carcinoma, long-term efficiency of local endoscopic resection was better than the surgery, and esophageal cancer specific mortality of patients underwent endoscopic resection could decrease. |
| keywords:superficial esophageal squamous cell carcinoma endoscopic resection surgery esophageal cancer specific mortality |
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