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Prognosis for local radical treatment in patients with esophageal squamous cell carcinoma with low-risk oligometastatic recurrence after curative resection: a retrospective cohort study.
Li, Tingting; Ke, Dongmei; Fu, Xiaobin; Dai, Yaqing; Lin, Jules; Anker, Christopher J; Bai, Zhigang; Li, Jiancheng.
Afiliación
  • Li T; Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
  • Ke D; Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
  • Fu X; Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
  • Dai Y; Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
  • Lin J; Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
  • Anker CJ; Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China.
  • Bai Z; Section of Thoracic Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
  • Li J; Division of Radiation Oncology, The University of Vermont Cancer Center, Burlington, VT, USA.
J Gastrointest Oncol ; 15(3): 807-817, 2024 Jun 30.
Article en En | MEDLINE | ID: mdl-38989428
ABSTRACT

Background:

Patients with esophageal carcinoma (EC) with recurrent disease have a poor prognosis. A limited numbers of metastases, safely treatable with curative intent, diagnosed after curative esophagectomy may be defined as oligometastatic recurrence (OLR). However, the appropriate number of metastases and metastatic organs involved remains incompletely characterized. And the role of local therapy in OLR after radical esophagectomy remains unknown. Therefore, this study aimed to more accurately define low-risk OLR in patients with esophageal squamous cell carcinoma (ESCC) treated with radical resection and investigate the role of chemotherapy combined with local treatment (CCLT) in these patients.

Methods:

A total of 83 sequential patients with ESCC who underwent radical esophagectomy, with an Eastern Cooperative Oncology Group (ECOG) performance status ≤2, with ability to tolerate chemotherapy (CT) and local treatment, and with newly diagnosed recurrence between January 2010 and May 2019 in our hospital were recruited. Overall survival (OS) curves after recurrence were analyzed using the Kaplan-Meier method, and a log-rank test was used to assess the OS differences. Cox proportional hazards regression analysis was performed to identify independent factors associated with 2-year OS. Regular follow-up examinations were assessed by thoracic and upper abdominal computed tomography (CT) scanning every 3 months in the first year, every 6 months over the next 2 years, and yearly thereafter.

Results:

Of the 83 patients with ESCC (71 males and 12 females), the median age was 56 years (range, 37-79 years). Thirty-five patients with ESCC with ≤5 metastases safely treatable with curative intent located in a single organ had a favorable OS compared to 48 patients with metastases located in 2-3 organs with or without regional recurrence and/or regional lymph node (LN) metastases. In our study, low-risk OLR was defined as the presence of ≤5 metastases safely treatable with curative intent in a single organ and was compared to patients with 2-3 organs involved. The 2-year OS of patients with low-risk OLR with liver oligometastases was significantly worse than survival in patients with lung oligometastases (0% vs. 61.1%, P=0.009). Patients with ESCC in the low-risk OLR group treated with CCLT had a better 2-year OS after recurrence than those who received CT alone (66.7% vs. 30.4%, P=0.003). The multivariable Cox regression model identified treatment method [hazard ratio (HR) 3.920, P=0.02] as an independent factor affecting OS after recurrence for low-risk OLR.

Conclusions:

Low-risk OLR was defined as ≤5 metastases safely treatable with curative intent in a single organ. Patients with ESCC with low-risk OLR after curative resection treated with CCLT have a favorable OS compared to those treated with CT alone. CCLT is a promising treatment option for patients with ESCC and low-risk OLR.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Gastrointest Oncol Año: 2024 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Gastrointest Oncol Año: 2024 Tipo del documento: Article País de afiliación: China
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