Can surgery for esophageal cancer improve my chances of survival?

Surgery for esophageal cancer may improve your chances of survival. A study showed that people with esophageal cancer who refuse surgery when it is recommended are less likely to survive long term than similar groups of people who undergo an operation. Although it may be tempting for people to opt for nonsurgical treatment for cardiothoracic diseases in order to avoid the perceived pain and complications of surgery, this choice may come with a price. Even if people recommended for surgery elect to pursue other treatments, they do more poorly than if they had included surgery as part of their treatment.

A study examined the data of 18,549 people with esophageal cancer from 2004 to 2014. Among these, the researchers identified 708 people who were recommended for surgery but declined. Within this group, instead of surgery, 41 percent (292) of people were treated with definitive chemoradiation, 36 percent (256) with sequential chemotherapy/radiation, 8.2 percent (58) with radiation and/or chemotherapy alone, and 14 percent (102) received no treatment.

Propensity matching was performed to compare the people who refused surgery to those treated with preoperative therapy followed by surgery (525 in each group). Median survival was significantly better in the group with preoperative therapy follwed by surgery than in the people who refused an operation, 32 months vs. 22 months, respectively.

Even after the groups were matched for other risk factors, the difference held up, with an absolute survival benefit of 12 percent at five years that favored people who underwent surgery.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.