Prognostic Factors and Survival Analysis in Esophageal Carcinoma

Abstract

Background: Despite recent advances in diagnosis and treatment, esophageal cancer still has high mortality. Prognostic factors associated with patient and with disease itself are multiple and poorly explored. Aim: Assess prognostic variables in esophageal cancer patients. Methods: Retrospective review of all patients with esophageal cancer in an oncology referral center. They were divided according to histological diagnosis (444 squamous cell carcinoma patients and 105 adenocarcinoma), and their demographic, pathological and clinical characteristics were analyzed and compared to clinical stage and overall survival. Results: No difference was noted between squamous cell carcinoma and esophageal adenocarcinoma overall survival curves. Squamous cell carcinoma presented 22.8% survival after five years against 20.2% for adenocarcinoma. When considering only patients treated with curative intent resection, after five years squamous cell carcinoma survival rate was 56.6 and adenocarcinoma, 58%. In patients with squamous cell carcinoma, poor differentiation histology and tumor size were associated with worse oncology stage, but this was not evidenced in adenocarcinoma. Conclusion: Weight loss (kg), BMI variation (kg/m²) and percentage of weight loss are factors that predict worse stage at diagnosis in the squamous cell carcinoma. In adenocarcinoma, these findings were not statistically significant.

Overexpression of Epidermal Growth Factor Receptor (EGFR) in Esophageal Squamous Cell Carcinoma and Its Correlation with Clinicopathological Characteristics in Central Uganda

“…The degree of ESCC differentiation in this study was similar to what was found by Chen et al [27] in which moderately differentiated cases were the majority (55.6%), followed by well differentiated (32.3%) and the least were poorly differentiated tumors (12.1%). In another study which was done in Japan by Tustumi et al [28] among patients with ESCC, it was found that moderately differentiated cases were the dominating cases constituting 73.7% similar to what we found for the cases in the present study.…”

Variables Associated to Pathologic Complete Response, Overall Survival and Disease-Free Survival in the Neoadjuvant Setting for Esophageal Cancer: A Retrospective Cohort Analysis

“…Large neoplasms and poor cellular differentiation are factors that can predict poor outcomes and, consequently, are usually related to advanced clinical stages. 10 Regarding locally advanced esophageal cancer, neoadjuvant therapy has been proven to yield better results and is currently considered the standard therapy. 11,12 In the setting of neoadjuvant therapy, only a few studies examined the relationship between prognostic variables and the change of these variables during neoadjuvant therapy.…”

Epidemiological Profile of Esophageal Cancer Mortality in Rio Grande do Sul and its Health Regions.

“…At diagnosis, about 60% of the cases are contraindicated for surgery due to the advanced state of the disease, when it compromises adjacent structures or presents with metastases 8,9 . The overall prognosis of survival in five years is just about 17%, confirming the severity of the neoplasia 10 .…”

“…Malignant neoplasm of the esophagus has a high mortality rate, reaching only 20% of survival in 5 years 10,19 , and 60% of the patients have an unresectable disease at the time of diagnosis 9 . Considering this lethality, mortality analysis data can infer epidemiological patterns, since diagnostic and mortality rates tend to be similar.…”