Research Paper Volume 16, Issue 8 pp 7131—7140

Treatment patterns and survival in T4b esophageal cancer: a retrospective cohort study

Bin-Bin Yu1, , Jiang-Qiong Huang1, , Huan-Wei Liang1, , Yang Liu1, , Long Chen1, , Su Pei1, , Wei Huang1, , Xin-Bin Pan1, ,

  • 1 Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi, P.R. China

Received: November 1, 2023       Accepted: March 18, 2024       Published: April 18, 2024
How to Cite

Copyright: © 2024 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Purpose: This study aims to evaluate the efficacy of various treatment approaches in stage T4b esophageal cancer patients.

Materials and methods: Data were extracted from the Surveillance, Epidemiology, and End Results databases, covering patients diagnosed with esophageal cancer between 2000 and 2020. Kaplan-Meier analysis was used to assess cancer-specific survival (CSS) and overall survival (OS) across different treatment patterns.

Results: The study included 482 patients: 222 (46.1%) received chemoradiotherapy, 58 (12.0%) underwent radiotherapy alone, 37 (7.7%) received chemotherapy alone, 50 (10.4%) underwent surgery, and 115 (23.8%) received no treatment. Median CSS were 12, 4, 6, 18, and 1 month for chemoradiotherapy, radiotherapy alone, chemotherapy alone, surgery, and non-treatment groups. Median OS for these groups were 11, 3, 6, 17, and 1 month, respectively. Multivariable proportional hazard regression analysis revealed that patients who underwent surgery experienced significantly improved CSS (hazard ratio [HR] = 0.42, 95% confidence interval [CI]: 0.24-0.72; P = 0.002) and OS (HR = 0.45, 95% CI: 0.28-0.74; P = 0.002) compared to those receiving chemoradiotherapy after propensity score matching.

Conclusions: Esophagectomy, with or without radiotherapy and/or chemotherapy, results in better survival outcomes than chemoradiotherapy in patients with stage T4b esophageal cancer.


OS: overall survival; SEER: the Surveillance, Epidemiology, and End Results; CSS: cancer-specific survival; HR: hazard ratio; CI: confidence interval; PSM: propensity score matching; IQR: interquartile range.