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©The Author(s) 2024.
World J Gastrointest Endosc. Feb 16, 2024; 16(2): 72-82
Published online Feb 16, 2024. doi: 10.4253/wjge.v16.i2.72
Published online Feb 16, 2024. doi: 10.4253/wjge.v16.i2.72
Table 1 Baseline patient characteristics before and after inverse probability of treatment weighting adjustment of patients treated by endoscopic submucosal dissection, surgery and definitive chemoradiotherapy
| Characteristic | Unmatched | IPTW | |||||||
| d-CRT | ESD | Surgery | P value | d-CRT | ESD | Surgery | P value | ||
| 16 | 99 | 220 | 9 | 157 | 207 | ||||
| Sex | Female | 5 (31.2) | 39 (39.4) | 53 (24.1) | 0.02 | 1 (11.1) | 24 (15.3) | 61 (29.5) | 0.228 |
| Male | 11 (68.8) | 60 (60.6) | 167 (75.9) | 8 (88.9) | 133 (84.7) | 146 (70.5) | |||
| Age | < 60 | 11 (68.8) | 44 (44.4) | 79 (35.9) | 0.02 | 8 (88.9) | 102 (65.0) | 29 (38.2) | 0.17 |
| ≥ 60 | 5 (31.2) | 55 (55.6) | 141 (64.1) | 1 (11.1) | 55 (35.0) | 128 (61.8) | |||
| Tumor location | Cervical | 0 | 3 (3.0) | 0 | < 0.001 | 0 | 1 (0.6) | 0 | 0.047 |
| Upper thoracic | 4 (25.0) | 13 (13.1) | 14 (6.4) | 0 | 5 (3.2) | 12 (5.8) | |||
| Middle thoracic | 4 (25.0) | 42 (42.4) | 111 (50.5) | 1 (10.5) | 27 (17.2) | 99 (47.8) | |||
| Lower thoracic | 5 (31.2) | 39 (39.4) | 87 (39.5) | 7 (77.4) | 121 (77.1) | 87 (42.0) | |||
| Multiple sources | 3 (18.8) | 2 (2.0) | 8 (3.6) | 1 (8.5) | 4 (2.5) | 9 (4.4) | |||
| Tumor's longest diameter in cm | < 3 | 5 (31.2) | 66 (66.7) | 93 (42.3) | < 0.001 | 1 (11.1) | 31 (19.7) | 93 (44.9) | 0.077 |
| ≥ 3 | 11 (68.8) | 33 (33.3) | 127 (57.7) | 8 (88.9) | 126 (80.3) | 114 (55.1) | |||
| Circumference ratio | < 3/4 | 12 (75.0) | 97 (98.0) | 178 (80.9) | < 0.001 | 8 (88.9) | 136 (86.6) | 176 (85.0) | 0.902 |
| ≥ 3/4 | 4 (25.0) | 2 (2.0) | 42 (19.1) | 1 (11.1) | 21 (13.4) | 31 (15.0) | |||
| Depth of infiltration | M1 | 4 (25.0) | 87 (87.9) | 49 (22.3) | < 0.001 | 2 (22.2) | 59 (37.6) | 85 (41.1) | 0.072 |
| M2 | 2 (12.5) | 4 (4.0) | 9 (4.1) | 6 (66.7) | 3 (1.9) | 9 (4.3) | |||
| M3-SM1 | 2 (12.5) | 3 (3.0) | 18 (8.2) | 0 | 8 (5.1) | 14 (6.8) | |||
| SM2-3 | 8 (50.0) | 5 (5.1) | 144 (65.5) | 1 (11.1) | 87 (55.4) | 99 (47.8) | |||
| Histology | Precancerous | 11 (68.8) | 89 (89.9) | 51 (23.2) | < 0.001 | 3 (33.3) | 61 (38.9) | 88 (42.5) | 0.422 |
| Well-differentiated SCC | 0 | 1 (1.0) | 7 (3.2) | 0 | 0 | 5 (2.4) | |||
| Moderately-differentiated SCC | 5 (31.2) | 6 (6.1) | 108 (49.1) | 6 (66.7) | 88 (56.1) | 77 (37.2) | |||
| Poorly-differentiated SCC | 0 | 3 (3.0) | 54 (24.5) | 0 | 8 (5.0) | 37 (17.9) | |||
| R0 resection or CR | No | 4 (25.0) | 8 (8.1) | 147 (66.8) | < 0.001 | 1 (11.1) | 88 (55.9) | 101 (48.8) | 0.544 |
| Yes | 12 (75.0) | 91 (91.9) | 73 (33.2) | 8 (88.9) | 69 (44.1) | 106 (51.2) | |||
| Complication | No | 9 (56.2) | 93 (93.9) | 143 (65.0) | < 0.001 | 7 (77.8) | 54 (34.4) | 151 (72.9) | 0.039 |
| Yes | 7 (43.8) | 6 (6.1) | 77 (35.0) | 2 (22.2) | 103 (65.6) | 56 (27.1) | |||
| Lymph node metastasis | N0 | 14 (87.5) | 96 (97.0) | 196 (89.1) | 0.059 | 9 (100.0) | 155 (98.7) | 189 (91.3) | 0.002 |
| N1-2 | 2 (12.5) | 3 (3.0) | 24 (10.9) | 0 | 2 (1.3) | 18 (8.7) |
Table 2 Complications before and after inverse probability of treatment weighting adjustment of patients treated by endoscopic submucosal dissection, surgery and definitive chemoradiotherapy
| Complication | Unmatched | IPTW | |||||||
| d-CRT | ESD | Surgery | P value | d-CRT | ESD | Surgery | P value | ||
| 16 | 99 | 220 | 9 | 157 | 207 | ||||
| Radiation pneumonitis | No | 15 (93.8) | 99 (100.0) | 220 (100.0) | < 0.001 | 9 (100.0) | 157 (100.0) | 207 (100.0) | 0.783 |
| Yes | 1 (6.2) | 0 | 0 | 0 | 0 | 0 | |||
| Aphonia | No | 16 (100.0) | 99 (100.0) | 218 (99.1) | 0.591 | 9 (100.0) | 157 (100.0) | 206 (99.5) | 0.745 |
| Yes | 0 | 0 | 2 (0.9) | 0 | 0 | 1 (0.5) | |||
| Pneumothorax | No | 16 (100.0) | 99 (100.0) | 214 (97.3) | 0.203 | 9 (100.0) | 157 (100.0) | 203 (98.1) | 0.537 |
| Yes | 0 | 0 | 6 (2.7) | 0 | 0 | 4 (1.9) | |||
| Dysphagia | No | 15 (93.8) | 99 (100.0) | 219 (99.5) | 0.01 | 9 (100.0) | 157 (100.0) | 206 (99.5) | 0.439 |
| Yes | 1 (6.2) | 0 | 1 (0.5) | 0 | 0 | 1 (0.5) | |||
| Anastomotic ulcer | No | 16 (100.0) | 99 (100.0) | 215 (97.7) | 0.265 | 9 (100.0) | 157 (100.0) | 204 (98.5) | 0.58 |
| Yes | 0 | 0 | 5 (2.3) | 0 | 0 | 3 (1.5) | |||
| Pulmonary infection | No | 16 (100.0) | 99 (100.0) | 206 (93.6) | 0.022 | 9 (100.0) | 157 (100.0) | 197 (95.2) | 0.308 |
| Yes | 0 | 0 | 14 (6.4) | 0 | 0 | 10 (4.8) | |||
| Anastomotic fistula | No | 16 (100.0) | 99 (100.0) | 192 (87.3) | < 0.001 | 9 (100.0) | 157 (100.0) | 187 (90.3) | 0.133 |
| Yes | 0 | 0 | 28 (12.7) | 0 | 0 | 20 (9.7) | |||
| Anastomotic or esophageal stenosis | No | 13 (81.2) | 95 (96.0) | 181 (82.3) | 0.004 | 9 (100.0) | 132 (84.1) | 178 (86.0) | 0.734 |
| Yes | 3 (18.8) | 4 (4.0) | 39 (17.7) | 0 | 25 (15.9) | 29 (14.0) | |||
| MOF | No | 16 (100.0) | 99 (100.0) | 213 (96.8) | 0.154 | 9 (100.0) | 157 (100.0) | 202 (97.6) | 0.489 |
| Yes | 0 | 0 | 7 (3.2) | 0 | 0 | 5 (2.4) |
Table 3 Incidence of hospitalization costs and salvage treatments after recurrence or metastasis before inverse probability of treatment weighting adjustment
| Parameter | ESD, n = 98 | Surgery, n = 220 | d-CRT, n = 16 |
| Follow up time | 40.0 (35.0-48.0) | 43.0 (34.0-53.75) | 32.5 (28.3-40.0) |
| Total cost | 25 | 100 | 130 |
| Death toll | 1 (1.0) | 19 (8.6) | 3 (18.8) |
| Recurrence | 4 (4.0) | 3 8(17.3) | 4 (25.0) |
| Salvage measures after recurrence or metastasis | Surgery (n = 3) | Surgery (n = 5) | Neoadjuvant chemo-radiotherapy (n = 1) |
| No treatment (n = 1) | Neoadjuvant radiotherapy (n = 4) | ||
| Neoadjuvant chemotherapy (n = 8) | |||
| Neoadjuvant chemo-radiotherapy (n = 15) | |||
| No treatment (n = 7) |
- Citation: Luo SA, Sun YY, Zeng YT, Huang CY. Comparative efficacy and safety between endoscopic submucosal dissection, surgery and definitive chemoradiotherapy in patients with cT1N0M0 esophageal cancer. World J Gastrointest Endosc 2024; 16(2): 72-82
- URL: https://www.wjgnet.com/1948-5190/full/v16/i2/72.htm
- DOI: https://dx.doi.org/10.4253/wjge.v16.i2.72