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Management of Clinical T1N0M0 Esophageal Cancer

机译：临床T1N0M0食管癌的管理

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Background/Aims Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. Methods In total, 179 patients with clinical T1N0M0-stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1a-stage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esophagectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions Endoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.
机译：背景/目的内镜切除术是T1a期食管癌的标准治疗方法，对T1b期食管癌行食管切除术或根治性放射治疗（RT）。这项研究旨在比较T1期食管癌临床每种方法的治疗效果。方法回顾性分析2006年至2016年治疗的179例T1N0M0期食管癌患者的临床资料。内镜切除了62例临床T1a期癌症患者。在117例临床T1b期癌症患者中，有82例接受了食管切除术，其中35例接受了放化疗或放疗。我们比较了每种治疗方式的总生存率（OS）和无复发生存率（RFS）。结果中位随访时间为32个月（范围1至120个月）。接受内镜切除的T1a期癌症患者的5年OS和RFS率分别为100％和85％。对于T1b期患者，食管切除术组的5年OS和RFS发生率分别为78％和77％。仅RT组分别为80％和44％;化学放射治疗组分别为96％和80％。食管切除术组的RFS显着高于单纯RT组（p = 0.04）。食管切除术组与化学放疗组之间的RFS差异无统计学意义（p = 0.922）。四名接受食管切除术的患者发生了4级或更高级别的治疗相关并发症。结论内镜切除术似乎是T1a期食管癌患者的适当治疗方法。 T1b期食管癌的生存结果无严重并发症，因此涉及化学放疗的多学科方法与食管切除术相当。

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