Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer

Terence T. Sio, Zachary C. Wilson, Michael C. Stauder, Sumita Bhatia, James A. Martenson, J. Fernando Quevedo, David A. Schomas, Robert C. Miller

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives: To determine long-term outcomes in patients with locally advanced esophageal carcinoma treated with trimodality therapy (chemoradiotherapy [CRT] and surgery, TMT) or definitive CRT. Methods: 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. Results: 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). Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)448-452
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number5
DOIs
StatePublished - Oct 1 2016

Keywords

  • adenocarcinoma
  • esophageal carcinoma
  • esophagectomy
  • radiotherapy
  • trimodality therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Sio, T. T., Wilson, Z. C., Stauder, M. C., Bhatia, S., Martenson, J. A., Quevedo, J. F., Schomas, D. A., & Miller, R. C. (2016). Long-term Treatment Outcomes for Locally Advanced Esophageal Cancer. American Journal of Clinical Oncology: Cancer Clinical Trials, 39(5), 448-452. https://doi.org/10.1097/COC.0000000000000089