A RECENT study comparing treatment strategies for stage T2N0M0 oesophageal cancer has revealed no significant survival advantage for patients receiving neoadjuvant chemoradiotherapy followed by surgery, compared to those undergoing surgery alone. The research, using data from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2020, examined the cancer-specific survival (CSS) and overall survival (OS) rates between the two treatment groups.
The study included 583 patients, with 267 (45.8%) receiving surgery alone and 316 (54.2%) undergoing neoadjuvant chemoradiotherapy followed by surgery. Initially, before adjusting for potential biases, there were no notable differences in 5-year CSS (60.86% vs. 59.02%) or OS (50.64% vs. 49.81%) between the two groups. After adjusting using propensity score matching, the outcomes remained similar, with 5-year CSS at 66.43% for surgery alone versus 56.67% for chemoradiotherapy, and OS at 56.49% versus 47.37%, respectively.
Subgroup analysis also showed no significant differences between the treatment modalities for patients with either squamous cell carcinoma or adenocarcinoma, the two main histological types of oesophageal cancer.
The findings suggest that, for patients with stage T2N0M0 oesophageal cancer, neoadjuvant chemoradiotherapy followed by surgery does not provide a survival benefit over surgery alone, regardless of the cancer’s histological subtype. These results challenge the routine use of chemoradiotherapy for this stage of the disease.
Reference
Lin Y et al. Surgery alone versus neoadjuvant chemoradiotherapy followed by surgery in patients with stage T2N0M0 esophageal cancer. Scientific Reports. 2024;14:28898.
