Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

Abstract

Esophageal carcinoma is an extremely deadly disease, and prognosis is poor. We retrospectively evaluated stage III esophageal carcinoma patients in our center. Median age of the patients was 52. Men to women ratio were 3/1. Epidermoid carcinoma was the major histology. Incidence of esophageal carcinoma was higher in the distal and middle third of the esophagus. In 19 patients tumor size was more than 5 cm. In total of 17 of the patients were operated. About 58 patients were irradiated. About 45 of the patients were irradiated with curative intent, 31 of them were primarily irradiated and 14 of them were irradiated postoperatively. Only 13 of the patients received concurrent chemoradiotherapy. Overall 1, 2, 3, and 4 year survival rates were 38.9%, 11.1%, 5.6%, and %1.9, respectively and median survival was 12 months. Median survival for tumors located in cervical esophageal, middle esophagus, and distal esophagus were 23, 8, and 14 months, respectively. One, 2, 3, 4 year survival rates of operated patients were 58.8%, 29.4%, 17.6%, 5.9%, respectively and median survival was 23 months. For inoperable patients 1 and 2 year survival rates were 29.7% and 2.7% and median survival was 8 months. Differences between operable and inoperable patients were statistically significant (P: 0.0003). One, 2, 3, 4 years survival results of patients treated with surgery and postoperative radiotherapy was 62.5%, 25%, 12.5%, 12.5% and median survival was 21 months, 1, 2, 3, 4 years survival results of patients treated with surgery and concurrent chemoradiotherapy was 55.6%, 33.3%, 22.2%, and 0% and median survival was 27 months. There was no statistically significant difference between groups (P: 0.5390). During the therapy, disphagia was the major side effect observed in seven patients. Fatigue, pain, and mild weight loss were the other side effects. Three patients could not tolerate the treatment and left the therapy. We demonstrated that stage III esophageal carcinoma is an extremely deadly disease, and in spite of major advances in cancer treatment, prognosis is still poor.

Comparison of Two Diverse Populations, British Columbia, Canada, and Ardabil, Iran, Indicates Several Variables Associated with Gastric and Esophageal Cancer Survival

“…In Ardabil, the low number of cases with a tumor in the esophagus’ upper third makes it difficult to derive any meaningful conclusion concerning this group. This result is consistent with a recent report from Turkey [18]. However, results from BC and other North American studies [1, 3] indicate that survival of patients with cancers in the upper, middle, and lower third of the esophagus are similar.…”

“…Patient characteristics include inherent and demographic characteristics such as age, sex, ethnicity, physical performance status, comorbidity, and immune status. These variables are usually unrelated to the presence of tumor but may have a profound impact on treatment choices [18]. The general treatment for esophageal and respectable gastric cancer was surgery.…”

The prognostic effect of ethnicity for gastric and esophageal cancer: the population-based experience in British Columbia, Canada

“…In addition, for studies of esophageal cancer, the location of tumors also showed differences in survival. Tumors in the middle 1/3 of the esophagus show worse survival in Turkey and Ardabil (Iran) [ 30 , 31 ], but tumors in the lower 1/3 of the esophagus are reported to have worse survival in BC and the United States[ 21 , 32 ].…”

Polymorphisms of survivin promoter are associated with risk of esophageal squamous cell carcinoma

“…ESCC is an extremely fatal disease. In spite of major advancement in cancer treatment, prognosis is still poor (Ugur et al 2008). Precise mechanisms that underlie esophageal cancer tumorigenesis are not yet fully understood.…”