Endoscopic Treatment Versus Esophagectomy For Stage T1N0M0 Middle And Lower Third Of Esophageal Cancer Base On SEER Datebase

ObjectiveTo evaluate the difference of overall survival(OS)and esophageal cancer-specific survival(ECSS)of early-stage esophageal cancer patients who undergoing endoscopic treatment or esophagectomy.MethodsPatient information was retrieved from the Surveillance,Epidemiology,and End Results(SEER)database.Propensity score matching(PSM)and Kaplan-Meier method and the log-rank test were used to compare OS and ECSS of 1777 patients with endoscopic treatment or esophagectomy for early-stage(T1N0M0)esophageal cancer.Subgroup analyses by T stage were also performed.ResultsThere were significant differences in age of diagnosis,cancer stage,differentiation grade,tumor histology and tumor size in the two treatment groups.PSM created 492 patient pairs.The results of OS and ECSS in patients with early esophageal cancer were similar for analyses to before matching stage T1,after matching stage T1,and Tla patients.However,the results of OS and ECSS in patients with stage T1b esophageal cancer ET both were no significant differences(Esophagectomy:91.430±5.043m vs Endoscopic treatment:64.321±6,950m,p=0.054;Esophagectomy:108.259±4.980 月vs Endoscopic treatment:98.282 ± 6.200 月,P=0.276).ConclusionFor early-stage esophageal cancer patients,especially those with stage Tla esophageal cancer,endoscopic treatment is feasible compared with esophagectomy and is a better available treatment method.Due to the advantages of surgery for lymph node dissection and evaluation,and base on the results of this study that the two treatment methods for T1b stage esophageal cancer patients have achieved a considerable survival rate,we suggest that endoscopy treatment can be used as an alternative treatment for T1b stage esophageal cancer patients who are highly selective or elderly or cannot tolerate esophagectomy.