Management of Liver Oligometastatic Esophageal Cancer: Overview and Critical Analysis of the Different Loco-Regional Treatments

Procopio, Fabio; Maranò, Stefano; Gentile, Damiano; Roit, Anna Da; Basato, Silvia; Riva, Pietro; Vita, Ferdinando De; Torzilli, Guido; Castoro, Carlo

doi:10.3390/cancers12010020

Cited by 10 publications

(6 citation statements)

References 57 publications

(84 reference statements)

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“…There is still a debate between two definitions: three to five synchronous metastatic foci in a single organ or metastatic disease affecting one or two organs with one or two foci per organ[ 11 ]. The size cutoffs accepted for oligometastatic foci is 3 cm[ 12 ]. Patients with this disease configuration could benefit from aggressive multimodal treatment with oncological treatment followed by surgery.…”

Section: Introductionmentioning

confidence: 99%

Multimodal treatment in oligometastatic gastric cancer

Chevallay¹,

Wassmer²,

Iranmanesh³

et al. 2022

WJGO

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Gastric cancer is generally diagnosed at an advanced stage, especially in countries without screening programs. Previously, the metastatic stage was synonymous with palliative management, and surgical indications were only for symptomatic relief. However, this therapeutic option is associated with poor prognosis. A subgroup of patients with limited metastatic disease could benefit from intensive treatment. A combination of chemotherapy, immunotherapy, and targeted therapy could help either maintain a resectable state for oligometastatic disease or diminish the metastasis size to obtain a complete resection configuration. This latter strategy is known as conversion therapy and has growing evidence with favorable outcomes. Oncosurgical approach of metastatic disease could prolong survival in selected patients. The challenge for the surgeon and oncologist is to identify these specific patients to offer the best multimodal management. We review in this article the actual evidence for the treatment of oligometastatic gastric cancer with curative intent.

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Section: Introductionmentioning

confidence: 99%

Multimodal treatment in oligometastatic gastric cancer

Chevallay¹,

Wassmer²,

Iranmanesh³

et al. 2022

WJGO

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“…Chemotherapy is the standard treatment for metastatic EC. With the current chemotherapy regimen, the duration of the response is short, and survival is usually 6 to 8 months [22] . Compared to the survival rate of patients who receive best supportive care, the survival rate of patients who receive chemotherapy alone is signi cantly higher (p=0.061) [16] .…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognostic Nomogram for Esophageal Cancer With Liver Metastasis Based on the Surveillance, Epidemiology, and End Results Database

Xiang

Xiong

et al. 2022

Preprint

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Background: The prognosis of esophageal cancer with liver metastasis (ECLM) is poor. This study evaluated the incidence and prognostic factors of ECLM at initial diagnosis and developed a visual nomogram to predict outcomes. Methods: 1892 eligible ECLM patients diagnosed between 2010 and 2016 were extracted from the Surveillance, Epidemiology, and End Results database (SEER). The incidence, patient overall survival (OS), and prognosis of liver metastasis were evaluated according to patient information, tumor characteristics, and therapy. Cox regression analyses were applied to evaluate prognostic factors. Based on the significant demographic and clinicopathologic factors, a novel visual nomogram was established to predict 6-month and 1-year survival for ECLM patients. Results: The incidence of ECLM increased with age, but survival rates showed the opposite trend. From 2010 to 2016, as age increased, the incidence also increased annually, peaking at age 70 to 79 years and then decreasing. The 1-, 3-, 6-, 9- and 12-month relative cancer survival rates for ECLM patients were 84.6%, 61.3%, 44.0%, 31.4%, and 21.8%, respectively. Multivariate cox regression analysis revealed that age, gender, grade, histological type, bone metastasis, lung metastasis, brain metastasis, chemotherapy and local treatment were independent prognostic factors related to OS. Moreover, our nomogram predicted the 6-month and 1-year survival times of the population, with a C-index of 0.735 (95% CI: 0.723-0.748). The nomogram demonstrated good clinical applicability. Conclusions: The incidence of ECLM increased with age, but survival rates showed the opposite trend. Age, gender, tumor characteristics, and therapy should be considered when predicting the prognosis of ECLM patients. The nomogram may improve clinicians’ abilities to predict individual survival and recommend treatments for ECLM patients.

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“…The median duration of survival of 23 months and 3-year OS rate of 41 per cent respectively, in the 12 patients with head and neck SCC in the present study, compares favourably with previously reported results of 18 months and 24 per cent respectively 1 . Oesophageal cancer still represents an aggressive disease and optimal management of patients with liver oligometastatic oesophageal cancer is still undefined 24 . Adam and colleagues reported a 3-year OS rate of 32 per cent in patients who underwent liver resection for liver metastases of oesophageal cancer (both adenocarcinoma and SCC) 1 .…”

Section: Discussionmentioning

confidence: 99%

Liver resection and ablation for squamous cell carcinoma liver metastases

et al. 2021

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Background Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method Members of the European–African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

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Management of Liver Oligometastatic Esophageal Cancer: Overview and Critical Analysis of the Different Loco-Regional Treatments

Cited by 10 publications

References 57 publications

Multimodal treatment in oligometastatic gastric cancer

Multimodal treatment in oligometastatic gastric cancer

Epidemiology and Prognostic Nomogram for Esophageal Cancer With Liver Metastasis Based on the Surveillance, Epidemiology, and End Results Database

Liver resection and ablation for squamous cell carcinoma liver metastases

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