Clinical results of multimodality therapy for esophageal cancer with distant metastasis

Abstract

Background: The purpose of this study is to evaluate outcomes in upfront local response and survival of patients with esophageal cancer and distant metastasis. Methods: This retrospective study included 34 patients (25 males) aged 42-92 years (median, 70 years) with a histological diagnosis of esophageal squamous cell cancer with distant metastasis. Staging was performed according to the UICC's TNM (6th edition) classification of malignant tumor. Results:The median survival time (MST) was 5 months. The 1-year overall survival (OS) was 20.6%.Improved OS was associated with receipt of surgery [hazard ratio (HR), 3.857; 95% CI, 1.142-13.024; P=0.030] on both univariate and multivariate analyses, and the MST was 11 months. The overall objective local response rate was 82%. Ten patients had complete response (CR), 18 had partial response (PR). The overall symptom response was 88% patients. Six had CR, 24 had PR. There was no significant difference in the objective and symptom response between ≤50 and >50 Gy. Concurrent chemoradiotherapy (CCRT) with 50 Gy gave results of objective and symptom responses comparable to those of 60 Gy, which has been reported previously. Conclusions: CCRT with 50 Gy gave results comparable to those of 60 Gy, which has been reported previously, and the toxicity was acceptable. Our findings showed that a multimodality therapy that includes surgery may improve survival in only a select group.

Local Ablative Treatment Improves Survival in ESCC Patients With Specific Metastases, 2010–2016: A Population-Based SEER Analysis

“…Metastatic ESCC patients had a poor prognosis, and the 5-year survival rate was no more than 5% ( 7 ). LAT to the primary or metastatic sites may be suitable choices that not only relieve symptoms to improve life quality but also prolong the survival time in metastatic ESCC patients ( 18 – 21 ). However, previous studies were mostly retrospective studies with a limited number of patients.…”

“…The radiation dose of palliative intent for metastatic EC reportedly ranges from 30 to 50 Gy ( 21 – 23 ). However, a higher radiation dose with a definitive aim appears to produce better survival outcomes in metastatic EC patients.…”

“…Patients who had surgery had a more satisfying disease-free survival (DFS) (14.6 months vs. 5.9 months, p = 0.021) and a better median OS [NR (not reached) vs. 20 months, p = 0.001] ( 20 ). Meanwhile, another retrospective research included 34 advanced ESCC patients with concurrent CRT and reported that the addition of surgery improved median survival time (MST) from 5.0 months to 11.0 months (HR = 3.857, 95% CI: 1.142–13.024, p = 0.030) ( 21 ).…”

Stereotactic Body Radiotherapy for Pulmonary Oligometastases from Esophageal Cancer: Results and Prognostic Factors

“…If these results are compared to previous results for esophageal cancer, our cohort showed longer survival. Actually, it has been reported that MSTs of patients with metastatic esophageal cancer were around 5 to 21 months (17)(18)(19)(20). Regarding recurrence after curative surgery for esophageal cancer, survival of patients with distant metastasis was worse than that of patients with locoregional recurrence (21,22).…”

Increased Risk of Esophageal Cancers Among Men in Taiwan

“…During later stages of the disease, patients may experience obstruction or dysphagia, but successful or curative treatment may be impossible at these stages. Complete surgical resection may be too difficult, and chemotherapy and radiotherapy may be insufficient after tumors have metastasized [7]. Research is needed to identify curative treatments for patients with esophageal squamous cell carcinoma (ESSC) and EADC.…”