Clinicopathological Characteristics and Survival Outcomes in Patients with Advanced Esophageal Squamous Cell Carcinoma Who Were Intraoperatively Diagnosed Non-Curative.
| Autor: | Sugase, Takahito, Kanemura, Takashi, Takeoka, Tomohira, Sugimura, Keijiro, Yamamoto, Masaaki, Shinno, Naoki, Hara, Hisashi, Omori, Takeshi, Mukai, Yosuke, Mikamori, Manabu, Hasegawa, Shinichiro, Haraguchi, Naotsugu, Akita, Hirofumi, Nishimura, Junichi, Wada, Hiroshi, Matsuda, Chu, Yasui, Masayoshi, Miyata, Hiroshi |
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| Předmět: |
SQUAMOUS cell carcinoma
CANCER invasiveness TREATMENT effectiveness DESCRIPTIVE statistics CHEMORADIOTHERAPY CHI-squared test MANN Whitney U Test SURGICAL complications DIGESTIVE organ surgery METASTASIS KAPLAN-Meier estimator DATA analysis software ESOPHAGEAL cancer OVERALL survival PROPORTIONAL hazards models |
| Zdroj: | Oncology; 2024, Vol. 102 Issue 5, p339-349, 11p |
| Abstrakt: | Introduction: Curative esophagectomy is not always possible in patients with locally advanced esophageal cancer. However, few studies have investigated patients who underwent non-curative surgery with intraoperative judgment. This study aimed to investigate patient characteristics and clinical outcomes for patients undergoing non-curative surgery and compare them between non-resectional and non-radical surgery. Methods: Among 989 consecutive patients with thoracic esophageal squamous cell carcinoma who were preoperatively expected for curative esophagectomy, 66 who were eligible for non-curative surgery were included in this study. Results: Intraoperative diagnosis of T4b accounted for 93% of the reasons for the failure of curative surgery. In those patients, esophageal cancer locally invaded into the aortobronchial constriction (70%), trachea (25%), or pulmonary vein (5%). Lymph node metastasis mainly invaded into the trachea (50%) or bronchus (28%). The overall survival of patients with non-curative surgery was 51.5%, 25.7%, and 10.4% at 6, 12, and 24 months after surgery, respectively. Although there were no differences in preoperative patient characteristics between non-resectional and non-radical surgery, distant metastasis, especially pleural dissemination, was significantly observed in T4b patients due to esophageal cancer with non-radical surgery than those with non-resectional surgery (35% vs. 15%, p = 0.002). Even in patients with non-curative surgery, R1 resection and postoperative chemoradiotherapy were identified as independent factors for survival 1 year after surgery (p = 0.047, and 0.019). Conclusions: T4b tumor located in aortobronchial constriction or trachea/bronchus makes it difficult to diagnose whether it is resectable or unresectable. Moreover, surgical procedures and perioperative treatment were deeply associated with the clinical outcomes. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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