Metastatic Esophageal Carcinoma: Prognostic Factors and Survival

Ghazy, Hosam; El-Hadaad, Hend Ahmed; Wahba, Hanan Ahmed; Abbas, Ramy; Abbas, Osama A.

doi:10.1007/s12029-021-00610-4

Cited by 8 publications

(6 citation statements)

References 31 publications

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“…This difference in results may be due to the different sample sizes of the two studies. This study also found that the higher the PS score and the shorter the PFS or OS, whether in the experimental or control group, indicating that the worse the general state, the poorer the body's tolerance to chemotherapy, and worse the prognosis, which was similar to previous studies 30 . The incidence of side effects was similar in the two groups, the patients could tolerate it, and raltitrexed did not increase side effects.…”

Section: Discussionsupporting

confidence: 88%

Efficacy and safety of irinotecan combined with raltitrexed or irinotecan monotherapy for salvage chemotherapy of esophageal squamous cell cancer: A prospective, open label, randomized phase II study

Dai

Tao

Wang³

et al. 2023

Cancer Medicine

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Background: Esophageal squamous cell cancer (ESCC) accounts for approximately 90% of esophageal cancer cases in China. There are no standard regimens for second or third–line chemotherapy of metastatic squamous esophageal cancer. The objective of this study was to investigate the security and effectiveness of irinotecan combined with raltitrexed or irinotecan monotherapy for salvage chemotherapy of ESCC.Methods: One hundred and twenty–eight patients with metastatic ESCC confirmed by histopathology were enrolled into this study. These patients had failure of the first–line chemotherapy combination of fluorouracil or platinum or paclitaxel and had not undergone chemotherapy with irinotecan or raltitrexed previously. Patients were randomly divided into irinotecan combined with raltitrexed group (experiment group) and irinotecan monotherapy group (control group). Overall survival (OS) and progression–free survival (PFS) were the primary endpoint.Results: In the control group, the median PFS (mPFS) and median OS (mOS) of patients were 3.37 and 5.3 months. In the experiment group, mPFS and mOS were 3.91 and 7.0 months. There was statistical significance of PFS and OS between two groups (PFS P = 0.002, OS P = 0.01). In subgroup analysis, in the second–line treatment, the mPFS of control and experiment group, was 3.90 and 4.60 months, mOS was 6.95 and 8.5 months, which was statistically significant differences between the two groups. (PFS P = 0.001, OS P = 0.005), In the third–line and beyond treatment, mPFS of control and experiment group was 2.80 and 3.19 months, mOS were 4.5 and 4.8 months. But there was no significant difference of PFS or OS between the two groups (PFS P = 0.19, OS P = 0.31). There was no statistical significance of toxicity side effects between two groups.Conclusions: The PFS and OS of irinotecan plus raltitrexed may be better than that of irinotecan monotherapy, especially in second line treatment, which should be confirmed with a phase III study including much more patients.

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Section: Discussionsupporting

confidence: 88%

Efficacy and safety of irinotecan combined with raltitrexed or irinotecan monotherapy for salvage chemotherapy of esophageal squamous cell cancer: A prospective, open label, randomized phase II study

Dai

Tao

Wang³

et al. 2023

Cancer Medicine

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“…Результаты российского исследования представляются похожими на данные других развивающихся стран. Например, в университетском египетском регистре, включившем 90 пациентов, 1-летняя ОВ составила 25,6% [12], в бразильском регистре с включением 397 пациентов медиана ОВ была 7,0 мес [13], и, наконец, в китайских регистрах, содержащих информацию о 5.283 пациентах с IV стадией болезни и 3.218 пациентах с метастатическим раком, медианы ОВ составили 23 и 5 мес, соответственно [14,15].…”

Section: Discussionunclassified

Overall Survival of Patients with Metastatic Esophageal Cancer: Russian Multicenter Registry Study

Тимофеев¹,

Bashmakova²,

Петкау³

et al. 2023

Voprosy Onkologii

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Актуальность: В 2019 г. в России было диагностировано 8.327 новых случаев рака пищевода и зарегистрировано 5.546 летальных исходов от этой опухоли. В настоящем регистровом исследовании оценивали общую выживаемость (ОВ) в реальной практике и подходы к лечению пациентов с впервые диагностированным в 2019-2020 гг. метастатическим раком пищевода. Материалы и методы: Ретроспективно выявлены больные в 7 онкологических учреждениях (8% всех онкологических учреждений) в различных регионах России (Екатеринбург, Красноярск, Москва, Нижний Новгород, Омск, Обнинск, Ростов-на-Дону). Центры расположены в южной, центральной и восточной частях страны. Обезличенные данные были собраны исследователями в регистр, включающий демографические данные, методы и результаты лечения. Пациенты были включены, если метастатический рак пищевода был диагностирован в период с января 2019 г. по январь 2020 г. Для участия в исследовании пациенты должны были иметь гистологически подтвержденный метастатический рак пищевода и возраст ≥18 лет на момент постановки диагноза. Первичным интересующим исходом была медиана ОВ. Результаты: 175 пациентов были включены в исследование для анализа. Среднее количество больных в одном регионе в год составило 29 человек. Все больные имели метастазы. Медиана возраста на момент постановки диагноза метастатического рака пищевода составила 63 (34-93) года (24% пациентов в возрасте ≥70 лет). Пациенты были преимущественно мужчинами (76%) с плоскоклеточным раком (69,3%). 159 (84%) и 134 (71%) пациентов не получали нео/адъювантную системную терапию или лучевую терапию соответственно. Системная химиотерапия использовалась для лечения метастатического рака у 85 (48,6%) пациентов. Наиболее часто назначаемой комбинацией был паклитаксел с цисплатином или карбоплатином (61/85, 72%). 24 (14%) пациента получили ≥2 линии лечения. Медиана ОВ составила 4,9 (95% ДИ, 3,86-5,94) месяцев. Медиана ОВ у пациентов, получавших системную терапию (11 мес; 95% ДИ 7,89–14,11), была значительно выше, чем у пациентов, не получавших терапию (2,4 мес; 95% ДИ 1,63–3,18; P<0,0001). Многофакторный регрессионный анализ Кокса показал, что на ОВ влияли наличие в анамнезе системной и лучевой терапии, а также частота ответов. Выводы: Результаты российского регистрового исследования свидетельствуют о необходимости дальнейшего внедрения современных рекомендаций и методов в реальную клиническую практику с целью увеличения продолжительности жизни больных раком пищевода.

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“…Qiu et al [31]incorporated radiomics and clinical features (including tumor differentiation) to predict postoperative recurrence risk of ESCC patients.And the C-index of test cohort was 0.724 in their combined model. In previous study, researchers had proved that ECOG PS had significant prognostic effects on clinical response and survival [32,33].And RE was regarded as one of the factors affecting patient's prognosis [34]. ECOG PS was used to evaluated the patient's physical performance before treatment and RE was the radiation-induced esophageal disease after treatment.…”

Section: Discussionmentioning

confidence: 99%

Machine learning models predict overall survival and progression free survival of non-surgical esophageal cancer patients with chemoradiotherapy based on CT image radiomics signatures

Cui

Xiang

et al. 2022

Radiat Oncol

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Purpose To construct machine learning models for predicting progression free survival (PFS) and overall survival (OS) with esophageal squamous cell carcinoma (ESCC) patients. Methods 204 ESCC patients were randomly divided into training cohort (n = 143) and test cohort (n = 61) according to the ratio of 7:3. Two radiomics models were constructed by radiomics features, which were selected by LASSO Cox model to predict PFS and OS, respectively. Clinical features were selected by univariate and multivariate Cox proportional hazards model (p < 0.05). Combined radiomics and clinical model was developed by selected clinical and radiomics features. The receiver operating characteristic curve, Kaplan Meier curve and nomogram were used to display the capability of constructed models. Results There were 944 radiomics features extracted based on volume of interest in CT images. There were six radiomics features and seven clinical features for PFS prediction and three radiomics features and three clinical features for OS prediction; The radiomics models showed general performance in training cohort and test cohort for prediction for prediction PFS (AUC, 0.664, 0.676. C-index, 0.65, 0.64) and OS (AUC, 0.634, 0.646.C-index, 0.64, 0.65). The combined models displayed high performance in training cohort and test cohort for prediction PFS (AUC, 0.856, 0.833. C-index, 0.81, 0.79) and OS (AUC, 0.742, 0.768. C-index, 0.72, 0.71). Conclusion We developed combined radiomics and clinical machine learning models with better performance than radiomics or clinical alone, which were used to accurate predict 3 years PFS and OS of non-surgical ESCC patients. The prediction results could provide a reference for clinical decision.

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Metastatic Esophageal Carcinoma: Prognostic Factors and Survival

Cited by 8 publications

References 31 publications

Efficacy and safety of irinotecan combined with raltitrexed or irinotecan monotherapy for salvage chemotherapy of esophageal squamous cell cancer: A prospective, open label, randomized phase II study

Efficacy and safety of irinotecan combined with raltitrexed or irinotecan monotherapy for salvage chemotherapy of esophageal squamous cell cancer: A prospective, open label, randomized phase II study

Overall Survival of Patients with Metastatic Esophageal Cancer: Russian Multicenter Registry Study

Machine learning models predict overall survival and progression free survival of non-surgical esophageal cancer patients with chemoradiotherapy based on CT image radiomics signatures

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