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Non-surgical treatment versus radical esophagectomy for clinical T1N0M0 esophageal carcinoma: a single-center experience.
[esophageal carcinoma]
The
role
of
non-surgical
treatments
(
NS
)
,
such
as
chemoradiotherapy
or
radiotherapy
,
for
clinical
T
1
N
0
M
0
esophageal
cancer
(
cT
1
N
0
M
0
EC
)
has
not
been
well
delineated
.
The
aim
of
this
study
was
to
evaluate
and
compare
the
feasibility
and
efficacy
of
NS
and
Surgical
treatment
(
S
)
in
cT
1
N
0
M
0
EC
patients
.
The
medical
records
of
patients
who
received
treatment
for
cT
1
N
0
M
0
EC
at
Asan
Medical
Center
between
2003
and
2012
were
retrospectively
reviewed
.
The
baseline
characteristics
,
treatment
outcomes
and
complications
,
and
survival
were
compared
.
There
were
264
S
and
20
NS
patients
with
respective
median
ages
of
69
.
5
and
63
.
0
.
The
main
histologic
finding
was
squamous
cell
carcinoma
in
both
groups
(
97
and
100
%
,
respectively
)
.
The
Eastern
Cooperative
Oncology
Group
performance
status
and
Charlson
comorbidity
index
score
were
poorer
in
the
NS
group
.
With
a
median
follow-up
of
49
.
0
months
,
37
S
patients
(
14
%
)
and
3
NS
patients
(
15
%
)
exhibited
recurrence
.
The
first
sites
of
recurrence
for
S
and
NS
patients
were
locoregional
(
21
vs
.
3
patients
)
,
distant
(
6
vs
.
0
)
,
and
both
locoregional
and
distant
(
9
vs
.
0
)
,
respectively
.
The
median
time-
to
-recurrence
could
not
be
calculated
in
either
group
(
log-rank
test
P
=
0
.
831
)
.
The
estimated
median
overall
survival
was
64
.
4
months
(
95
%
CI
37
.
2
-
91
.
6
months
)
in
the
NS
group
and
could
not
be
calculated
in
the
S
group
(
P
=
0
.
056
)
.
Non-surgical
treatments
can
be
an
effective
alternative
to
S
for
patients
with
cT
1
N
0
M
0
EC
unfit
for
radical
surgery
.
The
role
of
NS
for
early
stage
EC
needs
to
be
further
verified
with
prospective
randomized
trials
.
Diseases
Validation
Diseases presenting
"median overall survival"
symptom
cholangiocarcinoma
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
hodgkin lymphoma, classical
waldenström macroglobulinemia
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