The Impact of Pretreatment Esophageal Stenosis on Survival of Esophageal Cancer Patients

Sugawara, Katsuhiko; Fukuda, Takashi; Kishimoto, Yutaka; Oka, Daiji; Tanaka, Yoïchi; Yoshii, Takako; Kawashima, Yasunaru

doi:10.1245/s10434-022-12945-8

Cited by 6 publications

(4 citation statements)

References 45 publications

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“…T 4 and stenosis were also independent risk factors for esophageal fistula in patients treated by concurrent radiotherapy and chemotherapy [ 24 ]. However, there is no universally accepted definition of esophageal stenosis, which is usually determined based on the patient’s clinical symptoms and/or the findings of an endoscopic examination [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of malignant esophageal fistula in esophageal cancer using a radiomics-clinical nomogram

Zhu,

Sun,

Chen

et al. 2024

Eur J Med Res

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Background Malignant esophageal fistula (MEF), which occurs in 5% to 15% of esophageal cancer (EC) patients, has a poor prognosis. Accurate identification of esophageal cancer patients at high risk of MEF is challenging. The goal of this study was to build and validate a model to predict the occurrence of esophageal fistula in EC patients. Methods This study retrospectively enrolled 122 esophageal cancer patients treated by chemotherapy or chemoradiotherapy (53 with fistula, 69 without), and all patients were randomly assigned to a training (n = 86) and a validation (n = 36) cohort. Radiomic features were extracted from pre-treatment CTs, clinically predictors were identified by logistic regression analysis. Lasso regression model was used for feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the clinical nomogram, radiomics-clinical nomogram and radiomics prediction model. The models were validated and compared by discrimination, calibration, reclassification, and clinical benefit. Results The radiomic signature consisting of ten selected features, was significantly associated with esophageal fistula (P = 0.001). Radiomics-clinical nomogram was created by two predictors including radiomics signature and stenosis, which was identified by logistic regression analysis. The model showed good discrimination with an AUC = 0.782 (95% CI 0.684–0.8796) in the training set and 0.867 (95% CI 0.7461–0.987) in the validation set, with an AIC = 101.1, and good calibration. When compared to the clinical prediction model, the radiomics-clinical nomogram improved NRI by 0.236 (95% CI 0.153, 0.614) and IDI by 0.125 (95% CI 0.040, 0.210), P = 0.004. Conclusion We developed and validated the first radiomics-clinical nomogram for malignant esophageal fistula, which could assist clinicians in identifying patients at high risk of MEF.

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Section: Discussionmentioning

confidence: 99%

Prediction of malignant esophageal fistula in esophageal cancer using a radiomics-clinical nomogram

Zhu,

Sun,

Chen

et al. 2024

Eur J Med Res

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“…In ammation-based prognostic scores are reportedly useful for predicting long-term outcomes for EC patients with various tumor stages [18,23,24] and with recurrence [17]. Prior studies revealed short DFI to be associated with poor survival outcomes in patients with recurrence after EC surgery [5,8,17].…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes of esophageal cancer patients with recurrence after curative treatments

Sugawara

Oka

Yoshii

et al. 2023

Preprint

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Background: Little is known about predictive factors for survival outcomes of esophageal carcinoma (EC) patients who developed recurrence after undergoing multimodal therapies. We aimed to investigate long-term outcomes and identify prognostic factors in patients with relapsed EC, focusing especially on those with oligometastasis (OM).Methods: EC patients who developed recurrence after curative treatments (radical esophagectomy or definitive chemoradiotherapy (dCRT)) between 2010 and 2017 were reviewed. Multivariate Cox hazards models were applied to determine independent predictors of poor post-recurrence survival (PRS).Results: In total, 178 patients were included. The median PRS was 12.9 months. Of the 178 patients, 98 had OM and 80 non-OM (NOM) disease. The survival outcomes of patients with OM were significantly better than those of patients with NOM (P < 0.01). Surgical treatments provided significantly better survival outcomes than CRT or chemo-/radiotherapy alone (3-year overall survival (OS); 78.1% vs. 42.5% vs. 28.9%, P < 0.01), mainly due to prolonging survival after the recurrence (3-year PRS 62.9% vs. 16.7% vs. 16.2%, P < 0.01). Multivariable analysis focusing on patients with OM revealed cStage III-IV disease (P < 0.01), high GPS at the time of recurrence (P = 0.02) and non-curative treatments (P < 0.01), to be independently associated with poor PRS. In contrast, in patients with NOM, no independent predictors for poor PRS were identified.Conclusions: The survival outcomes of patients with relapsed EC remain poor. Surgical treatments provided significantly better survival outcomes than other treatment modalities, especially in patients with OM, mainly due to prolonging survival after the recurrence.

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“…, in the recent article entitled, "The impact of pretreatment esophageal stenosis on survival in esophageal cancer patients," examined a Japanese cohort of 496 consecutive patients within an 8-year period, of which 51 had esophageal stenosis. 1 Although not universal, the definition of stenosis is objectively and clearly defined as patients where a 5-6-mm diameter endoscope could not be passed through the tumor site of narrowing. The authors used multiple validated pretreatment prognostic tools: Onodera's prognostic nutritional index, the Glasgow prognostic score (GPS), and the Charlson comorbidity index.…”

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confidence: 99%

“…The authors used multiple validated pretreatment prognostic tools: Onodera's prognostic nutritional index, the Glasgow prognostic score (GPS), and the Charlson comorbidity index. 1,2 All patients were treated based on the algorithms established by the Japan Esophageal Society guidelines: for T1N1-3 or T2-4a (any N disease), neoadjuvant chemotherapy followed by surgery was performed. 3 In general, patients were not stented.…”

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confidence: 99%

Stenosis in Esophageal Cancer: A Poor Prognostic Indicator

Kwon,

Popoff

2023

Ann Surg Oncol

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The Impact of Pretreatment Esophageal Stenosis on Survival of Esophageal Cancer Patients

Cited by 6 publications

References 45 publications

Prediction of malignant esophageal fistula in esophageal cancer using a radiomics-clinical nomogram

Prediction of malignant esophageal fistula in esophageal cancer using a radiomics-clinical nomogram

Survival outcomes of esophageal cancer patients with recurrence after curative treatments

Stenosis in Esophageal Cancer: A Poor Prognostic Indicator

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