Prognostic risk factors for T1 thoracic esophageal cancer: a retrospective cohort study

BACKGROUND: Esophageal cancer has a poor overall prognosis and a high incidence of post-treatment complications. This study aimed to analyze the common surgical methods for treating T1 thoracic esophageal cancer and explore its prognostic risk factors to provide a basis for appropriate treatment selection. METHODS: In this population-based retrospective cohort study, data of patients diagnosed with T1 thoracic esophageal cancer from 2010 to 2016 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were divided according to those who had surgery and those who had radiotherapy. Survival curves were generated using the Kaplan-Meier method and validated by the log-rank test. Cox’s regression model was used to analyze the independent prognostic risk factors. RESULTS: Overall, 2,027 eligible patients, including 824 and 1,203 patients in the surgical and non-surgical groups, respectively, were analyzed. There was no significant difference in survival between the surgical and non-surgical groups (P=0.79). In subgroup analysis, the Cox regression analysis showed that radiotherapy was a significant prognostic factor (P=0.00059). CONCLUSIONS: The impact of surgery on patients with T1 thoracic esophageal cancer was insignificant; however, radiotherapy was an independent prognostic risk factor. These results provide a reliable basis for clinical treatment of patients with T1 thoracic esophageal cancer.