br Fig Kaplan Meier K

Fig 1. Kaplan-Meier (K-M) survival curves for (A) all esophageal squa-mous cell carcinoma (SCC) patients,
(B) clinical stage I patients, (C) clin-ical stage II patients, and (D) clinical stage III patients stratified based on treatment with definitive chemo-radiotherapy (CRT) versus esoph-agectomy (p < 0.0001 for all).
Fig 2. Kaplan-Meier (K-M) survival
curves for (A) all esophageal SCC
and (D) clinical stage III patients (p ¼
definitive chemoradiotherapy (CRT)
versus esophagectomy after propensity
matching. 
GENERAL THORACIC
THORACIC  1064 WANG ET AL Ann Thorac Surg
GENERAL  were 26.14% and 46.17%, respectively (p < 0.001, Table 2). The overall survival curve of the unmatched patients according to clinical stage was stratified by treatment strategy (Fig 1). The survival curve of the unmatched patients is shown in Figure 1A. Patients treated with esophagectomy alone had a significantly superior 3-year overall survival rate (p < 0.0001). The survival curve was assessed according to clinical stage, and for clinical stages I, II, and III, respectively, the overall survival rate of patients receiving esoph-agectomy alone was better than that Vorinostat of patients treated by definitive CRT (p < 0.001, Figs 1B–D).
The overall survival rates of matched patients are shown in Figure 2. When patients were divided into different clinical stages, the overall survival rate in pa-tients undergoing esophagectomy alone was higher in clinical stages I and II. Analysis of the propensity-matched clinical stage III patients demonstrated that there was no significant difference between the two groups (p ¼ 0.2455, Fig 2D).  Univariate survival analysis for unmatched patients identified sex, clinical T, clinical N, clinical stage, grade, location, length, and treatment modality as prognostic factors. Regarding univariate survival analysis for matched patients, Charlson score, clinical T, clinical N, clinical stage, tumor length, and treatment modality were identified as the prognostic factors (Table 3).
In multivariate analysis, sex, Charlson score, clinical T, clinical N, clinical stage, grade, tumor location, tumor length, and treatment modality were predictors of overall survival. Multivariate analysis after propensity score matching demonstrated microsporangia sex, Charlson score, clinical T, clinical N, grade, tumor length, and treatment modality remained the prognostic factors (Table 4).
Comment
We investigated the overall survival of patients with locoregional esophageal SCC who were treated with definitive CRT or esophagectomy alone in Taiwan. The
Table 3. Univariate Analysis for All Patients Before and After Propensity Matching
All Patients
Propensity-Matched Patients
Characteristics HR 95% CI p Value HR 95% CI p Value
Male 1
Well differentiated/ moderately differentiated 1
Upper 1
Definitive chemoradiotherapy 1
CI ¼ confidence interval; HR ¼ hazard ratio.
Ann Thorac Surg
ESOPHAGECTOMY IN ESOPHAGEAL CANCER
Table 4. Multivariate Analysis for All Patients Before and After Propensity Matching
All Patients
Propensity-Matched Patients
Characteristics
Age (years)
Sex
Male
Female
Charlson score
Clinical T
Clinical N
Clinical stage
I
II
III
Grade
Well/moderately differentiated 1
Tumor location
Upper
Lower
Middle
Tumor length
Treatment modality
Definitive chemoradiotherapy 1
Esophagectomy
AHR ¼ adjusted hazard ratio; CI ¼ confidence interval.