Outcomes of Definitive Chemoradiotherapy for Cervical and Upper Thoracic Esophageal Cancers: A Single-Institution Experience of a Rare Cancer Publisher Pubmed



Esmati E¹ ; Maddah Safaei A¹ ; Ghalehtaki R¹ ; Mousavi N² ; Saraee E² ; Shirouei S² ; Mohammadi N¹ ; Lashkari M¹ Show Affiliations
Source: Journal of Gastrointestinal Cancer Published:2019

Abstract

Purpose: Upper esophageal carcinomas are uncommon but confer a poor prognosis. However, there is scarcity of data regarding outcomes of definitive chemoradiotherapy for cervical and upper thoracic esophageal squamous cell carcinoma in Iran. Methods: In this retrospective cohort study, we analyzed data of patients with squamous cell carcinoma of cervical and upper thoracic esophagus (at 16 to 25 cm from incisors) treated by definitive chemoradiotherapy in our institution between 2007 and 2015. The primary outcome was overall survival and secondary endpoints were predictors of overall survival. Results: From 2007 to 2015, 40 patients were entered to final analysis. The mean age of patients was 59.7 ± 14.3 (range 24–85 years). Sixteen (40%) were node-positive. The median follow-up time was 15.3 months. Twenty-seven patients (67.5%) died during post treatment period. Thirty-five percent and 25% of patients suffered from local and distant recurrences, respectively. The actuarial median overall survival was 19.2 (CI 95% 14.2–24.2) months. The 1- and 2-year overall survival rates were 76 and 38%, respectively. The overall survival was higher among patients who were younger than 50 years, of female gender, had stage II tumor, grades I to II, who received induction chemotherapy, and whom treated with doses < 60 Gy. However, none of the differences was statistically significant. Conclusions: Cervical and upper thoracic esophageal squamous cell carcinomas are associated with bad outcome. Studies with bigger sample sizes are required to define best treatment strategies. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.