en Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: To compare radical surgery with definitive radiotherapy for upper third esophageal squamous cell carcinoma. Materials and Methods: A total of 191 patients were included in the study. Patients&rsquo; clinicopathologic features, and survival time were recorded. Kaplan-Meier (K-M) analysis was adopted to analyze Overall survival (OS), Disease-free survival(DFS), Progression-free survival(PFS), and a Cox multivariate model was used to adjust potential confound factors. Results: The K-M survival analysis showed that treatments, location of lesion, and length of lesion were all associated with the OS (P<0.005). In the surgery group, K-M survival&nbsp; showed that T stage (T1 vs T2, P=0.012, T1 vs T3, P=0.002), location (upper vs upper merged middle, P<0.001), and length lesion (<5 cm vs >5 cm, P=0.015), affected the OS，T stage (T1 vs T2, P=0.018, T1 vs T3, P=0.020) and location of lesion (upper vs upper merged middle, P=0.007) was associated with DFS. The Cox model showed that none of these parameters independently influenced the OS and DFS. In the radiotherapy group, K-M survival showed that supraclavicular lymph node metastasis (P=0.007), concurrent chemo-radiotherapy (P=0.012), and sex (P=0.047) influenced the OS，adjuvant chemotherapy (P=0.013) and age (P=0.013) influenced PFS, The Cox model showed that supraclavicular lymph node metastasis (P=0.018) independently influenced OS and adjuvant chemotherapy (P=0.046) independently influenced PFS. Conclusion: Surgery has better therapeutic effect than radiotherapy. Patients with an upper merged middle lesion and advanced T stage for surgery, male, local advanced and without concurrent chemo-radiotherapy for radiotherapy have a poor prognosis.</div> Esophageal upper squamous cell carcinoma, surgery, radiotherapy. 595 603 http://ijrr.com/browse.php?a_code=A-10-1-822&slc_lang=en&sid=1 X.S. Hu 7900319475328460014088 7900319475328460014088 Yes Department of of Oncology, The Second Xiangya Hospital of Central South University, 410011Changsha, Hunan, China＆Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China S.M. Wen 7900319475328460014089 7900319475328460014089 No Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China J. Bie 7900319475328460014090 7900319475328460014090 No Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China F. Xian 7900319475328460014091 7900319475328460014091 No Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China W.W. He 7900319475328460014092 7900319475328460014092 No Department of Thoracic Surgery, Sichuan Cancer Hospital and Research Institute, 610000Chengdu, Sichuan, China D. Li 137666745@qq.com 7900319475328460014093 7900319475328460014093 No Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China