Radiation oncology (London, England)
July 15, 2026 · via Europe PMC
Postoperative adjuvant therapy for pT3N0M0 esophageal carcinoma: does radiotherapy offer added benefit beyond chemotherapy?
Yang T, Wang X, Liu J, Ma R, Wu L, Wang Q, Qi Y, Wang Y
AI summary — for doctors, generated from the abstract only
For resected pT3N0M0 esophageal squamous cell carcinoma, adding radiotherapy to postoperative chemotherapy did not significantly improve overall or disease-free survival in a propensity-matched analysis.
What was studied
Retrospective single-center study (2009-2020) of 356 pT3N0M0 TESCC patients receiving postoperative chemotherapy (274) or chemoradiotherapy (82), with propensity matching (82 per group).
Key findings
- 5-year OS 70.9% overall
- Matched 5-year OS 65.3% (chemo) vs 71.4% (chemoradiation), not significant
- Matched 5-year DFS 63.3% vs 70.9%, not significant
- Lower-third tumors showed DFS benefit with chemoradiation in subgroup analysis
Clinical relevance
This suggests routine postoperative RT may not add clear survival benefit in pT3N0 TESCC, though selected subgroups (e.g., lower third) may warrant study.
Who should care
Limitations
Retrospective with small chemoradiation group and limited power.
Adding radiation to postoperative chemotherapy did not clearly help node-negative T3 esophageal squamous cancer.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND AND PURPOSE
The optimal postoperative adjuvant treatment for pathological T3N0M0 (pT3N0M0) thoracic esophageal squamous cell carcinoma (TESCC) remains unclear. This study evaluated whether adding radiotherapy to postoperative chemotherapy provides an additional survival benefit in these patients.
METHODS
We retrospectively reviewed 1,090 TESCC patients treated at Sichuan Cancer Hospital (2009-2020). After applying inclusion and exclusion criteria, 356 patients who received adjuvant therapy were analyzed: 274 underwent surgery plus postoperative chemotherapy (S+POCT) and 82 received surgery plus postoperative chemoradiotherapy (S+POCRT). Propensity score matching balanced baseline characteristics between groups. Overall survival (OS) and disease-free survival (DFS) were compared, and survival predictors were assessed using a Cox proportional hazards model.
RESULTS
Before matching, the S+POCRT group had more female patients, and patients with vascular or perineural invasion were more likely to receive chemoradiotherapy. After matching (82 patients per group), baseline characteristics were balanced. The 5-year OS was 70.9% for the entire cohort. In the matched cohort, 5-year OS rates were 65.3% (S+POCT) versus 71.4% (S+POCRT), and 5-year DFS rates were 63.3% versus 70.9%, respectively. No statistically significant differences in OS or DFS were observed between the two groups. Multivariate analysis indicated that neither postoperative chemotherapy nor chemoradiotherapy independently improved OS. In the subgroup analysis, patients with tumors located in the lower third of the esophagus were more likely to derive a significant DFS benefit from S+POCRT but no subgroup showed a statistically significant OS benefit from S+POCRT compared with S+POCT.
CONCLUSIONS
For pT3N0M0 TESCC patients undergoing R0 resection without neoadjuvant therapy, postoperative chemotherapy alone provides comparable survival to chemoradiotherapy in the overall retrospective cohort. These findings suggest that the routine addition of postoperative radiotherapy to chemotherapy may not provide a clear survival advantage in the overall pT3N0M0 TESCC population. Further prospective studies are needed to identify patients who may benefit from postoperative radiotherapy.
CLINICAL TRIAL NUMBER
Not applicable.
DOI
10.1186/s13014-026-02886-x
PMID
42458490
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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