{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T17:32:52Z","timestamp":1768671172392,"version":"3.49.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Methods<\/jats:title><jats:p>Surgical esophagectomy is falsely regarded as contributing little survival in resectable, early\u2010stage disease in favor of nonsurgical treatment with definitive chemoradiation (dCR). We examine surgery in treatment by evaluating large\u2010scale trends in mortality. The SEER database was queried for esophageal cancer patients from 2004 to 2020. Total of 59\u2009754; 19\u2009806 squamous and 34\u2009484 adenocarcinoma. The primary outcome was the hazard ratio for overall survival defined as time from diagnosis\u2010to\u2010death. Differences between patients were assessed using \u03c7<jats:sup>2<\/jats:sup> tests for categorical variables and <jats:italic>t<\/jats:italic>\u2010tests for continuous variables. Difference in survival by histology was assessed using Kaplan\u2010Meier curves and Cox Proportional Hazards models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 47\u2009170 (78.9%) did not undergo surgery and 12\u2009584 (21.1%) received surgery. The hazard ratio for patients undergoing dCR for SCC was 1.929. The hazard ratio for treatment with dCR compared to chemoradiation\u2010followed\u2010by\u2010surgery (CRS) was 2.151 and for adenocarcinoma 2.386. Further analyses highlight groups under similar clinical conditions; including multivariate analysis, T\u2010Stage, overall stage, surgical era, and surgery refusal. In every category, the risk of mortality was higher in dCR compared to CRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgery combined with chemoradiation, and\/or surgery alone, confers a significant survival benefit over dCR in resectable patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Surgery should be considered early in medically fit patients with operable disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.70085","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:24:06Z","timestamp":1757917446000},"page":"977-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stop Canceling Surgery for Esophageal Cancer: An Analysis of Treatment Related Mortality in 60\u2009000 Patients"],"prefix":"10.1002","volume":"132","author":[{"given":"Brian","family":"Housman","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubham","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Icahn School of Medicine at Mount Sinai, New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwin","family":"Kulshrestha","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Icahn School of Medicine at Mount Sinai, New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Untalan","sequence":"additional","affiliation":[{"name":"Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai, New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Ivic\u2010Pavlicic","sequence":"additional","affiliation":[{"name":"Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai, New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Tuminello","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai, New York New York USA"},{"name":"Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4576-6355","authenticated-orcid":false,"given":"Karyn 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