Improved Survival of Primary-Tumor Resection in Metastatic Thoracic Esophageal Cancer: A Population-Based, Propensity Score Matched Study

The study aims to assess the survival effect of primary-tumor resection (PTR) on thoracic esophageal cancer with distant metastasis(TECDM). Data of patients with TECDM was collected from the Surveillance, Epidemiology, and End Results database from 2010 to 2020. We used a 1:1 propensity-score matching(PSM) analysis to minimize heterogeneity between different groups. Total 7733 patients with TECDM were included, and 121 patients and 7612 patients underwent primary-tumor resection and did not, respectively. Patients underwent primary-tumor resection had a better median OS and median CSS than those patients did not in overall and PSM cohort. In PSM cohort, the median OS was 11 months (95% CI, 9 months to 13 months) for TECDM patients with PTR and 7 months (95% CI, 5 months to 9 months) for those patients without PTR. Additionally, cox proportional hazard models similarly indicated that PTR was a significantly protective factor for TECDM patients in OS (HR: 0.5529; 95% CI, 0.5196 to 0.7730, P < 0.001) and CSS (HR:0.5869 ; 95% CI, 0.479 to 0.7192, P < 0.001). In conclusion, primary-tumor resection prolongs survival of thoracic esophageal cancer patients with distant metastasis.