{
  "abstract": "Background: Surgery and chemoradiotherapy (CRT) are standard options for clinical stage I esophageal squamous cell carcinoma (ESCC). JCOG0502, a multicenter, non-randomized, parallel-group comparison, demonstrated the non-inferiority of definitive CRT compared with surgery for overall survival (OS) in patients with cT1bN0M0 ESCC; however, institutional differences may influence outcomes. This study explored inter-institutional heterogeneity in survival and adverse events (AEs) among patients in JCOG0502.\n\nMethods: Among 379 enrolled patients, 364 were analyzed. Institutions enrolling ≥ 13 patients, corresponding to the median institutional trial enrollment, were classified as high-enrollment institutions (High), whereas those enrolling < 13 patients were classified as low-enrollment institutions (Low). Institutional trial enrollment was evaluated as an exploratory indicator, rather than as a direct measure of institutional case or procedural volume. The primary endpoint was OS. Secondary endpoints were progression-free survival (PFS) and AEs.\n\nResults: In the surgery group, institutional trial enrollment volume was not significantly associated with OS (HR for High vs. Low, 0.73; 95% CI, 0.40–1.35). Similarly, no significant association was observed in the CRT group (HR, 1.12; 95% CI, 0.59–2.13). Findings for PFS were consistent with these OS results in both groups. Myocardial ischemia or infarction occurred in 5 patients in Low and none in High in the CRT group.\n\nConclusions: No clear association was identified between institutional trial enrollment volume and survival outcomes in either the surgery or CRT group. However, clinically meaningful differences could not be excluded. The observed differences in selected toxicities, including myocardial ischemia, should be considered hypothesis-generating.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01244-w.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan",
    "JCOG Data Center/Operations Office, National Cancer Center Hospital, Chuo City, Japan",
    "Department of Esophageal Surgery, National Cancer Center Hospital, Chuo City, Japan",
    "Department of Radiation Oncology, Showa Medical University School of Medicine, Tokyo, Japan",
    "Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan",
    "Division of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan",
    "Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan",
    "Department of Gastroenterological Surgery, Toranomon Hospital, Minato, Japan",
    "Department of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan",
    "Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan",
    "Department of Surgery, Kyoto University, Kyoto, Japan",
    "Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan",
    "Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan",
    "Department of Surgical Oncology, Hiroshima University, Higashihiroshima, Japan",
    "Department of Gastrointestinal Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan",
    "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan",
    "Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan",
    "Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kazuhiro Shiraishi"
    },
    {
      "affs": [
        0
      ],
      "name": "Ken Kato",
      "orcid": "0000-0002-1733-5072"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuya Ishikawa"
    },
    {
      "affs": [
        1
      ],
      "name": "Keita Sasaki"
    },
    {
      "affs": [
        2
      ],
      "name": "Hiroyuki Daiko"
    },
    {
      "affs": [
        3
      ],
      "name": "Yoshinori Ito"
    },
    {
      "affs": [
        4
      ],
      "name": "Takeshi Kajiwara"
    },
    {
      "affs": [
        5
      ],
      "name": "Takashi Kojima"
    },
    {
      "affs": [
        6
      ],
      "name": "Hiroshi Miyata"
    },
    {
      "affs": [
        7
      ],
      "name": "Masaki Ueno"
    },
    {
      "affs": [
        8
      ],
      "name": "Satoru Nakagawa"
    },
    {
      "affs": [
        9
      ],
      "name": "Shinsuke Sato"
    },
    {
      "affs": [
        10
      ],
      "name": "Shigeru Tsunoda"
    },
    {
      "affs": [
        11
      ],
      "name": "Tetsuya Abe"
    },
    {
      "affs": [
        12
      ],
      "name": "Yoshiaki Nagatani"
    },
    {
      "affs": [
        13
      ],
      "name": "Yoichi Hamai"
    },
    {
      "affs": [
        14
      ],
      "name": "Yasue Kimura"
    },
    {
      "affs": [
        15
      ],
      "name": "Kenro Hirata"
    },
    {
      "affs": [
        16
      ],
      "name": "Takahiro Tsushima"
    },
    {
      "affs": [
        17
      ],
      "name": "Hiroya Takeuchi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bzarpeh7yhfc2.bib",
  "cited_by": 0,
  "doi": "10.1007/s10388-026-01244-w",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723696/",
  "id": "bzarpeh7yhfc2",
  "issns": [
    "1612-9059",
    "1612-9067"
  ],
  "landing_url": "https://doi.org/10.1007/s10388-026-01244-w",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7204442839",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s10388-026-01244-w.pdf",
  "pmcid": "PMC13723696",
  "pmid": "42658443",
  "published": "2026-08-27",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bzarpeh7yhfc2.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:17Z",
      "native_id": "PMC13723696",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s10388-026-01244-w"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Institutional enrollment volume and clinical outcomes after surgery or chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma: a supplementary analysis of JCOG0502",
  "title_text": "Institutional enrollment volume and clinical outcomes after surgery or chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma: a supplementary analysis of JCOG0502",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:28Z",
  "url": "https://research.draconitic.com/paper/bzarpeh7yhfc2",
  "venue": "Esophagus",
  "versions": []
}