Esophagectomy: Is It Necessary after Chemoradiotherapy for a Locally Advanced T4 Esophageal Cancer? Prospective Nonrandomized Trial Comparing Chemoradiotherapy with Surgery versus without Surgery

2004 ◽  
Vol 29 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Hiromasa Fujita ◽  
Susumu Sueyoshi ◽  
Toshiaki Tanaka ◽  
Yuichi Tanaka ◽  
Satoru Matono ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Locally Advanced ◽  
Nonrandomized Trial ◽  
T4 Esophageal Cancer

Outcomes associated with T4 esophageal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 130-130
Author(s):  
K. Meredith ◽  
J. Weber ◽  
R. Shridhar ◽  
S. E. Hoffe ◽  
K. Almhanna ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Pathologic Response ◽  
Additional Patient ◽  
Free Survival ◽  
T4 Esophageal Cancer ◽  
Disease Free

130 Background: Esophageal cancer often presents as locally advanced disease with 15% of patients having T4 tumors upon diagnosis. Esophagectomy was often reserved for palliation given the dismal survival rates and high rates of R1/R2 resections. However, neoadjuvant therapy (NT) has the potential to significantly downstage esophageal cancers and thus increase complete resection rates. We report our experience with surgically resected T4 cancers of the esophagus. Methods: Using a comprehensive esophageal cancer database, we identified patients who underwent an esophagectomy for T4 tumors between 1994 and 2008. Neoadjuvant therapy and pathologic response were recorded and denoted as complete (pCR), partial (pPR), and non-response (NR). Clinical and pathologic data were compared using Fisher's exact and chi-square when appropriate while Kaplan Meier estimates were used for survival analysis. Results: We identified 39 patients with T4 tumors who underwent esophagectomy of which 38 (97%) underwent NT. The median age was 61 (31-79) years with a median follow-up of 32 (5-97) months. There were 3 (7.9%) pCR, 17 (44.7%) pPR, and 18 (47.4%) NR. R0 resections were accomplished in 37 (94.9%). Two patients had incomplete resections. One patient had a R2 resection after NT and was deemed as NR. An additional patient had a R1 resection after NT and was a pPR with a residual 0.2 cm tumor on permanent pathology. There were 14 (35.9%) recurrences with a median time to recurrence of 19.5 (4-71) months. Complete pathologic response represented 1 (7.1%), whereas pPR and NR represented 6 (42.9%), and 7 (50%) respectively of all recurrences. The overall and disease free survival for all patients with T4 tumors was 28% and 34% respectively. Patients achieving a pCR had a 5-year overall and disease free survival of (43% and 47%), compared to pPR (30% and 21%) while there were no 5-year survivors in the NR cohort. Conclusions: T4 esophageal cancer often portends a dismal prognosis even after surgical resection. Historical incomplete resections and dismal survival rates often make surgery palliative rather then curative. However, we have demonstrated that neoadjuvant therapy and down staging of T4 tumors leads to increased R0 resections and improvements in overall and disease free survival. No significant financial relationships to disclose.

T4 esophageal cancer treated with radical resection

2020 ◽  
Vol 61 (4) ◽  
Author(s):  
Hai Zhong ◽  
Qianjun Li ◽  
Wenhui Gao ◽  
Xiang Li ◽  
Junhua Zhang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radical Resection ◽  
T4 Esophageal Cancer

PO-1070: Effect of surgery in locally advanced esophageal cancer after chemoradiotherapy

2020 ◽  
Vol 152 ◽  
pp. S568
Author(s):  
I. Alda Bravo ◽  
S. Fernandez Alonso ◽  
M. Alarza Cano ◽  
M.Á. Pérez-Escutia ◽  
R. D'Ambrossi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Locally Advanced ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

630 IMPACT OF LOW SKELETAL MUSCLE MASS AND DENSITY ON OUTCOMES OF LOCALLY ADVANCED ESOPHAGEAL CANCER PATIENTS TREATED WITH RADICAL RADIOTHERAPY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Yuan Wang ◽  
Ningjing Yang ◽  
Hongyuan Jia ◽  
Long Liang ◽  
Lei Wu ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Esophageal Cancer ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Mass Density ◽  
Locally Advanced ◽  
Radical Radiotherapy ◽  
Term Survival ◽  
Locally Advanced Esophageal Cancer

Abstract   Low skeletal muscle mass and density are independent predictors of clinical outcomes in multiple gastrointestinal cancers. However, its effect on the long-term survival of locally advanced esophageal cancer patients undergoing radical radiotherapy is still unclear. Methods Patients with stage II-III esophageal cancer undergoing radical radiotherapy, enrolled in a observational cohort study, were included. Skeletal muscle mass and density were measured on CT. Patients with high and low skeletal muscle mass and density were compared regarding overall survival (OS). Results 165 patients (75.8% males, median age 63) were included, from March-2012 to September-2017. Before radiotherapy, 26.7% patients had low skeletal-muscle-mass and 23.0% patients had low skeletal-muscle-density. After radiotherapy, 40.6% patients had low skeletal-muscle-mass and 30.3% patients had low skeletal-muscle-density.The median OS of high skeletal-muscle-mass/density group was significantly higher than that of low skeletal-muscle-mass/density group before radiotherapy (28.7 vs 28.2 months, p = 0.041; 29.6 vs 16.9 months, p = 0.025). The median OS of high skeletal-muscle-mass/density group was also significantly higher than that of low skeletal-muscle-mass/density group after radiotherapy (30.3 vs 20.3 months, P = 0.012; 29.6 vs 17.2 months, p = 0.018). Conclusion Low skeletal muscle mass and density are associated with long-term outcome in patients undergoing radical radiotherapy. It is suggested that oncologists should pay more attention to the management of muscle mass and density of patients with esophageal cancer undergoing radiotherapy in order to improve their nutritional status and long-term survival.

Sign in / Sign up

Export Citation Format

Share Document