The risk and prognostic factors for liver metastases in esophageal cancer patients: A large‐cohort based study

Abstract

Background: This retrospective study aimed to explore risk factors for liver metastases (LiM) in patients with esophageal cancer (EC) and to identify prognostic factors in patients initially diagnosed with LiM. Methods: A total of 28 654 EC patients were retrieved from the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. A multivariate logistic regression model was utilized to identify risk factors for LiM. A Cox regression model was used to identify prognostic factors for patients with LiM. Results: Of 28 654 EC patients, 4062 (14.2%) had LiM at diagnosis. The median overall survival (OS) for patients with and without LiM was 6.00 (95% CI: 5.70-6.30) months and 15.00 (95% CI: 14.64-15.36) months, respectively. Variables significantly associated with LiM included gender, age, tumor site, histology, tumor grade, tumor size, clinical T stage, clinical N stage, bone metastases (BoM), brain metastases (BrM) and lung metastases (LuM). Variables independently predicting survival for EC patients with LiM were age, histology, tumor grade, BoM, BrM, LuM, and chemotherapy. A risk prediction model and two survival prediction models were then constructed revealing satisfactory predictive accuracy. Conclusions: Based on the largest known cohort of EC, independent predictors of LiM and prognostic indicators of survival for patients with LiM were identified. Two models for predicting survival as well as a risk prediction model were developed with robust predictive accuracy.

Comparing the Efficacy of Carboplatin plus 5-Fluorouracil, Cisplatin plus 5-Fluorouracil, and Best Supportive Care for Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score Analysis from a Tertiary Hospital in Southern Thailand

“…Additionally, liver metastasis can result in complications such as liver failure, jaundice, and ascites, significantly affecting a patient’s quality of life and contributing to disease severity. Our study’s results align with Luo’s findings, in which the presence of liver metastasis led to shorter survival [ 45 ]. In the liver metastasis group, individuals with upper esophageal cancer had the worst survival rates, followed by those with middle- and lower-segment involvement [ 46 ].…”

The effect of liver metastases on clinical efficacy of first‐line programmed death‐1 inhibitor plus chemotherapy in esophageal squamous cell carcinoma: A post hoc analysis of ASTRUM‐007 and meta‐analysis

“…There were two studies which suggested that the presence of liver metastases was an unfavorable prognostic factor in patients with esophageal cancer including both squamous cell carcinoma and adenocarcinoma 21,22 . A large cohort‐based study demonstrated that esophageal cancer patients with liver metastases had shortened OS compared with those without liver metastases (6.00 months vs. 15.00 months) 21 . In another cohort of patients with stage IV esophageal cancer from the Surveillance, Epidemiology, and End Results (SEER) database, liver metastasis was identified as one of the independent risk factors for early death (defined as death within 3 months of diagnosis) 22 .…”

“… 21 , 22 A large cohort‐based study demonstrated that esophageal cancer patients with liver metastases had shortened OS compared with those without liver metastases (6.00 months vs. 15.00 months). 21 In another cohort of patients with stage IV esophageal cancer from the Surveillance, Epidemiology, and End Results (SEER) database, liver metastasis was identified as one of the independent risk factors for early death (defined as death within 3 months of diagnosis). 22 Of note, these previous studies were performed before immune checkpoint inhibitors were used in advanced esophageal cancer patients.…”

“…There were two studies which suggested that the presence of liver metastases was an unfavorable prognostic factor in patients with esophageal cancer including both squamous cell carcinoma and adenocarcinoma 21,22 . A large cohort‐based study demonstrated that esophageal cancer patients with liver metastases had shortened OS compared with those without liver metastases (6.00 months vs. 15.00 months) 21 .…”

Prediction of hepatic metastasis in esophageal cancer based on machine learning

“…However, liver metastasis in esophageal cancer engenders a substantial impact on patient prognosis. Not only does it signal advanced-stage disease, but it also portends a poor prognosis, resulting in metabolic disorders due to liver dysfunction, circulatory problems stemming from liver failure, pain, weight loss, and the potential development of multiple organ dysfunction syndrome (MODS) in the advanced stages 25 .…”