Esophagectomy for locally advanced esophageal cancer, followed by chemoradiotherapy and adjuvant chemotherapy

Table 1 Characteristics of patients

Characteristics	CCRT1n (%)	RT alone1n (%)
Gender
Male	30 (100)	27 (90)
Female	0 (0)	3 (10)
Mean age±SD (yr)	59.9 ± 10.0	62.2 ± 6.7
ECOG performance status
0	18 (60)	18 (60)
1	11 (36.7)	10 (33.3)
2	1 (3.3)	2 (6.7)
Tumor size±SD (cm)	3.7 ± 1.0 (2.0-5.0)	4.5 ± 0.96 (2.0-6.0)
Location of tumor
Upper-third	7 (23.3)	2 (6.7)
Middle-third	19 (63.3)	22 (73.3)
Lower-third	4 (13.3)	6 (20.0)
Mean radiation dosage±SD (cGy)	5 880 ± 98	5 832 ± 274
Histologic classification
Well differentiated	9 (30.0)	7 (23.3)
Moderately differentiated	9 (30.0)	10 (33.3)
Poorly differentiated	12 (40.0)	13 (43.3)
Pathological disease staging
T3N0	11 (36.7)	11 (36.7)
T3N1	4 (13.3)	6 (20.0)
T4N0-1	15 (50.0)	13 (33.3)
T stage
T3	15 (50.0)	17 (56.7)
T4	15 (50.0)	13 (43.3)
N stage
N0	22 (73.3)	19 (63.3)
N1	8 (26.7)	11 (36.7)

¹All items have been calculated with no significant difference between treatment groups with t-test for continuous variables and χ² test for categorical variables. CCRT: Surgery plus concurrent chemoradiotherapy. RT alone: Surgery plus radiotherapy alone.

Table 2 Treatment outcome

	CCRT (n = 30, %)	RT alone (n = 30, %)
3-yr survival	70	33.7
Local recurrence	40	60
Distant metastasis	27	57

Table 3 Status after surgery and causes of death

	CCRT (n = 30)	RT alone (n = 30)
Alive at last follow-up	21	11
Metastasis
Lymph nodes	14	13
Regional	12	71
Distant	2	9
Lung	3	3
Liver	1	3
Bone	2	2
Causes of death	9	19
Esophageal cancer	7	12
Pneumonia	0	2
Cardiovascular disease	1	2
Gastrointestinal bleeding	1	2
Hepatic failure	0	1

¹Three patients had both regional and distant nodal metastases.

Table 4 Cox multivariate analysis

Characteristics	Patient number	P	Hazard ratio (95% CI)
Adjuvant therapy
RT vs	30	<0.001	5.83 (2.36-14.43)
CCRT	30
Cell differentiation
Poor vs	25	0.001	5.88 (2.08-16.93)
Well/moderate	35
Tumor size
≤ 4.1 cm vs	30	0.058	2.68 (0.97-7.43)
> 4.1 cm	30
Age (yr)
≤ 61.7 yr vs	28	0.48	1.34 (0.60-2.99)
>61.7 yr	32
Nodal status
Yes vs	41	0.06	2.71 (1.00-7.38)
No	19
T status
T4 vs	28	0.532	1.47 (0.44-4.92)
T3	32

CI: confidence interval.

Table 5 Toxicity assessment

	CTC grades CCRT/RT
	0	1	2	3	4
Renal toxicity	21/26	9/4	0/0	0/0	0/0
Anemia	21/19	3/6	1/2	5/3	0/0
Leukopenia	20/23	5/5	5/2	0/0	0/0
Thrombocytopenia	25/26	0/0	4/2	1/2	0/0
Nausea, vomiting	3/6	14/14	12/10	0/0	0/0
Esophagitis/mucositis	10/15	15/8	5/7	0/0	0/0
Dermatitis	9/14	13/11	8/5	0/0	0/0
Pneumonitis	25/22	5/7	0/1	0/0	0/0
Stenosis	24/20	6/10	0/0	0/0	0/0