Outcome for esophageal cancer following treatment with chemotherapy and radiotherapy but not esophagectomy: nonsurgical treatment of esophageal cancer
Urs Zingg1,2, Dennis DiValentino1, Alexander McQuinn1, Ahmad Mardzuki1, Sarah K Thompson2, Christos S Karapetis1,3, David I Watson1
1Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia; 2Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia; 3Department of Medical Oncology, Flinders Medical Centre, Bedford Park, South Australia, Australia
Background: More than 50% of patients with esophageal cancer are not suitable for surgery. The aim of this study was to analyze the outcome of patients undergoing standard nonsurgical treatment.
Methods: Data of all patients undergoing nonsurgical treatment for esophageal cancer were identified from a prospective database.
Results: Seventy-five patients were treated for localized disease, and 52 for metastatic disease at diagnosis. Except for age, which was higher in patients without metastases, there were no significant differences between the patients with vs. without metastatic disease. Kaplan–Meier analysis showed a median survival of 10.8 months for all patients. There was a significant difference in survival (p < 0.001) between the groups with versus without metastases, with median survival in the patients without metastases 13.6 months versus 6.5 months in patients with metastases. Patients undergoing nonsurgical treatment for localized disease had a five-year survival of 12%. No significant difference between adenocarcinoma and squamous cell carcinoma was identified. Subanalysis of patients who received chemoradiotherapy revealed similar results to the overall group of patients.
Conclusion: In patients with localized disease at diagnosis, long-term survival can be achieved in some patients, whereas five-year survival is rare in patients who present with metastatic disease.
Keywords: nonsurgical treatment, esophageal cancer, chemoradiotherapy, metastases, survival
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