Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer: A Single-Institution Experience
To determine long-term outcomes in patients with locally advanced esophageal carcinoma treated with trimodality therapy (chemoradiotherapy [CRT] and surgery, TMT) or definitive CRT. We retrospectively identified patients with advanced esophageal carcinoma treated with curative intent at our institut...
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| Veröffentlicht in: | American journal of clinical oncology 2016-10, Vol.39 (5), p.448-452 |
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| creator | Sio, Terence T Wilson, Zachary C Stauder, Michael C Bhatia, Sumita Martenson, James A Quevedo, J Fernando Schomas, David A Miller, Robert C |
| description | To determine long-term outcomes in patients with locally advanced esophageal carcinoma treated with trimodality therapy (chemoradiotherapy [CRT] and surgery, TMT) or definitive CRT.
We retrospectively identified patients with advanced esophageal carcinoma treated with curative intent at our institution between 1998 and 2004. Identified patients were separated into 3 groups: patients who received TMT, patients who received CRT, and patients who began treatment with trimodality intent but did not undergo surgery (PTMT). Local control, overall survival (OS), and distant metastasis-free survival were compared using Kaplan-Meier statistics.
Among the 265 patients included, median follow-up was 6.4 years for surviving patients and 1.7 years for all patients. Type of esophageal cancer was adenocarcinoma in 213 patients (80%) and squamous cell carcinoma in 46 patients (17%). Treatment groups comprised 169 patients (64%) completing TMT, 46 patients medically unable to undergo surgery after neoadjuvant therapy (PTMT), and 50 (19%) who underwent CRT. Median OS was 20.5 months; actuarial 5- and 10-year OS were 27% and 12%, respectively. The TMT group had the highest 5- and 10-year OS (32% and 19%, respectively). Local control rates at 2, 5, and 10 years for all patients were 80%, 70%, and 69%, respectively. By treatment modality, 5-year local control was best (82%) for TMT, compared with 60% for CRT and 40% for PTMT groups (P |
| doi_str_mv | 10.1097/COC.0000000000000089 |
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We retrospectively identified patients with advanced esophageal carcinoma treated with curative intent at our institution between 1998 and 2004. Identified patients were separated into 3 groups: patients who received TMT, patients who received CRT, and patients who began treatment with trimodality intent but did not undergo surgery (PTMT). Local control, overall survival (OS), and distant metastasis-free survival were compared using Kaplan-Meier statistics.
Among the 265 patients included, median follow-up was 6.4 years for surviving patients and 1.7 years for all patients. Type of esophageal cancer was adenocarcinoma in 213 patients (80%) and squamous cell carcinoma in 46 patients (17%). Treatment groups comprised 169 patients (64%) completing TMT, 46 patients medically unable to undergo surgery after neoadjuvant therapy (PTMT), and 50 (19%) who underwent CRT. Median OS was 20.5 months; actuarial 5- and 10-year OS were 27% and 12%, respectively. The TMT group had the highest 5- and 10-year OS (32% and 19%, respectively). Local control rates at 2, 5, and 10 years for all patients were 80%, 70%, and 69%, respectively. By treatment modality, 5-year local control was best (82%) for TMT, compared with 60% for CRT and 40% for PTMT groups (P<0.001).
Patients who completed TMT had the best local control and long-term OS. In the context of TMT, surgery seemed more beneficial in patients with esophageal adenocarcinoma versus squamous cell carcinoma.</description><identifier>ISSN: 0277-3732</identifier><identifier>EISSN: 1537-453X</identifier><identifier>DOI: 10.1097/COC.0000000000000089</identifier><identifier>PMID: 24879469</identifier><language>eng</language><publisher>United States</publisher><subject>Adenocarcinoma - secondary ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Squamous Cell - secondary ; Carcinoma, Squamous Cell - therapy ; Chemoradiotherapy, Adjuvant ; Cisplatin - administration & dosage ; Disease-Free Survival ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - therapy ; Esophagectomy ; Female ; Fluorouracil - administration & dosage ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Radiotherapy Dosage ; Survival Rate ; Time Factors ; Treatment Outcome</subject><ispartof>American journal of clinical oncology, 2016-10, Vol.39 (5), p.448-452</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c186t-894321c9151359f8361efea4efe5adb9ec25b2ff64029898d7f55093ee2950593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24879469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sio, Terence T</creatorcontrib><creatorcontrib>Wilson, Zachary C</creatorcontrib><creatorcontrib>Stauder, Michael C</creatorcontrib><creatorcontrib>Bhatia, Sumita</creatorcontrib><creatorcontrib>Martenson, James A</creatorcontrib><creatorcontrib>Quevedo, J Fernando</creatorcontrib><creatorcontrib>Schomas, David A</creatorcontrib><creatorcontrib>Miller, Robert C</creatorcontrib><title>Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer: A Single-Institution Experience</title><title>American journal of clinical oncology</title><addtitle>Am J Clin Oncol</addtitle><description>To determine long-term outcomes in patients with locally advanced esophageal carcinoma treated with trimodality therapy (chemoradiotherapy [CRT] and surgery, TMT) or definitive CRT.
We retrospectively identified patients with advanced esophageal carcinoma treated with curative intent at our institution between 1998 and 2004. Identified patients were separated into 3 groups: patients who received TMT, patients who received CRT, and patients who began treatment with trimodality intent but did not undergo surgery (PTMT). Local control, overall survival (OS), and distant metastasis-free survival were compared using Kaplan-Meier statistics.
Among the 265 patients included, median follow-up was 6.4 years for surviving patients and 1.7 years for all patients. Type of esophageal cancer was adenocarcinoma in 213 patients (80%) and squamous cell carcinoma in 46 patients (17%). Treatment groups comprised 169 patients (64%) completing TMT, 46 patients medically unable to undergo surgery after neoadjuvant therapy (PTMT), and 50 (19%) who underwent CRT. Median OS was 20.5 months; actuarial 5- and 10-year OS were 27% and 12%, respectively. The TMT group had the highest 5- and 10-year OS (32% and 19%, respectively). Local control rates at 2, 5, and 10 years for all patients were 80%, 70%, and 69%, respectively. By treatment modality, 5-year local control was best (82%) for TMT, compared with 60% for CRT and 40% for PTMT groups (P<0.001).
Patients who completed TMT had the best local control and long-term OS. In the context of TMT, surgery seemed more beneficial in patients with esophageal adenocarcinoma versus squamous cell carcinoma.</description><subject>Adenocarcinoma - secondary</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Squamous Cell - secondary</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Chemoradiotherapy, Adjuvant</subject><subject>Cisplatin - administration & dosage</subject><subject>Disease-Free Survival</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Esophagectomy</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Staging</subject><subject>Radiotherapy Dosage</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0277-3732</issn><issn>1537-453X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1Lw0AQhhdRbK3-A5E9ekndj2yy662EqoVCD1bwFrabSY0k2bi7EfvvTWkVdA4zMDzvDDwIXVMypUSld9kqm5I_JdUJGlPB0ygW_PUUjQlL04innI3QhffvAyISkp6jEYtlquJEjVGxtO02CuAavHagQwNtwKs-GNuAx6V1eGmNrusdnhWfujVQ4Lm33Zvegq5xtt-4ezzDz1W7rSFatD5UoQ-VbfH8qwNXwUBcorNS1x6ujnOCXh7m6-wpWq4eF9lsGRkqkxBJFXNGjaKCcqFKyRMKJeh4aEIXGwWGiQ0ryyQmTEkli7QUgigOwJQgQvEJuj3c7Zz96MGHvKm8gbrWLdje51QyFieCUjag8QE1znrvoMw7VzXa7XJK8r3ffPCb__c7xG6OH_pNA8Vv6Eco_wZRZHWz</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Sio, Terence T</creator><creator>Wilson, Zachary C</creator><creator>Stauder, Michael C</creator><creator>Bhatia, Sumita</creator><creator>Martenson, James A</creator><creator>Quevedo, J Fernando</creator><creator>Schomas, David A</creator><creator>Miller, Robert C</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201610</creationdate><title>Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer: A Single-Institution Experience</title><author>Sio, Terence T ; Wilson, Zachary C ; Stauder, Michael C ; Bhatia, Sumita ; Martenson, James A ; Quevedo, J Fernando ; Schomas, David A ; Miller, Robert C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c186t-894321c9151359f8361efea4efe5adb9ec25b2ff64029898d7f55093ee2950593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - secondary</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Squamous Cell - secondary</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Chemoradiotherapy, Adjuvant</topic><topic>Cisplatin - administration & dosage</topic><topic>Disease-Free Survival</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - therapy</topic><topic>Esophagectomy</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm Staging</topic><topic>Radiotherapy Dosage</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sio, Terence T</creatorcontrib><creatorcontrib>Wilson, Zachary C</creatorcontrib><creatorcontrib>Stauder, Michael C</creatorcontrib><creatorcontrib>Bhatia, Sumita</creatorcontrib><creatorcontrib>Martenson, James A</creatorcontrib><creatorcontrib>Quevedo, J Fernando</creatorcontrib><creatorcontrib>Schomas, David A</creatorcontrib><creatorcontrib>Miller, Robert C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sio, Terence T</au><au>Wilson, Zachary C</au><au>Stauder, Michael C</au><au>Bhatia, Sumita</au><au>Martenson, James A</au><au>Quevedo, J Fernando</au><au>Schomas, David A</au><au>Miller, Robert C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer: A Single-Institution Experience</atitle><jtitle>American journal of clinical oncology</jtitle><addtitle>Am J Clin Oncol</addtitle><date>2016-10</date><risdate>2016</risdate><volume>39</volume><issue>5</issue><spage>448</spage><epage>452</epage><pages>448-452</pages><issn>0277-3732</issn><eissn>1537-453X</eissn><abstract>To determine long-term outcomes in patients with locally advanced esophageal carcinoma treated with trimodality therapy (chemoradiotherapy [CRT] and surgery, TMT) or definitive CRT.
We retrospectively identified patients with advanced esophageal carcinoma treated with curative intent at our institution between 1998 and 2004. Identified patients were separated into 3 groups: patients who received TMT, patients who received CRT, and patients who began treatment with trimodality intent but did not undergo surgery (PTMT). Local control, overall survival (OS), and distant metastasis-free survival were compared using Kaplan-Meier statistics.
Among the 265 patients included, median follow-up was 6.4 years for surviving patients and 1.7 years for all patients. Type of esophageal cancer was adenocarcinoma in 213 patients (80%) and squamous cell carcinoma in 46 patients (17%). Treatment groups comprised 169 patients (64%) completing TMT, 46 patients medically unable to undergo surgery after neoadjuvant therapy (PTMT), and 50 (19%) who underwent CRT. Median OS was 20.5 months; actuarial 5- and 10-year OS were 27% and 12%, respectively. The TMT group had the highest 5- and 10-year OS (32% and 19%, respectively). Local control rates at 2, 5, and 10 years for all patients were 80%, 70%, and 69%, respectively. By treatment modality, 5-year local control was best (82%) for TMT, compared with 60% for CRT and 40% for PTMT groups (P<0.001).
Patients who completed TMT had the best local control and long-term OS. In the context of TMT, surgery seemed more beneficial in patients with esophageal adenocarcinoma versus squamous cell carcinoma.</abstract><cop>United States</cop><pmid>24879469</pmid><doi>10.1097/COC.0000000000000089</doi><tpages>5</tpages></addata></record> |
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| subjects | Adenocarcinoma - secondary Adenocarcinoma - therapy Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Squamous Cell - secondary Carcinoma, Squamous Cell - therapy Chemoradiotherapy, Adjuvant Cisplatin - administration & dosage Disease-Free Survival Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Esophagectomy Female Fluorouracil - administration & dosage Humans Male Middle Aged Neoadjuvant Therapy Neoplasm Staging Radiotherapy Dosage Survival Rate Time Factors Treatment Outcome |
| title | Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer: A Single-Institution Experience |
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