scholarly journals Predicting Individual Survival After Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

2020 ◽  
Author(s):  
Zhiyong Zhao ◽  
Xiaolong Huang ◽  
Zhu Chen ◽  
Biao Zhu ◽  
Limin Gan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Accuracy ◽  
Disease Free Survival ◽  
Chronic Obstructive ◽  
Radical Esophagectomy ◽  
Term Survival

Abstract Background Esophageal cancer is one of the leading causes of cancer-related death worldwide 1 . Despite significant progress in the overall treatment of esophageal cancer in recent years, the prognosis for patients who require surgery remains poor. Methods The current paper studied the clinicopathological features of 503 patients who underwent radical esophagectomy at the Huashan Hospital of Fudan University between January 2005 and January 2015. Nomograms which predicted esophageal squamous cell carcinoma (ESCC) survival rates were established using the Cox proportional hazards regression model. Discrimination and calibration, calculated after bootstrapping, were used as a measure of accuracy. Results Multivariate analyses were used to select five independent prognostic variables to build the nomogram. These variables were pathological T stage, pathological N factor, rate of positive LNs, history of chronic obstructive pulmonary disease (COPD) and postoperative sepsis. The nomogram was built to predict the rates of overall survival (OS) and disease-free survival (DFS). The concordance indices of the nomogram prediction of OS and DFS were 0.720 and 0.707, respectively. Compared to the conventional TNM staging system, the nomogram has better predictive accuracy for survival (OS 0.720 vs 0.672, P<0.001; DFS 0.707 vs 0.667, P<0.001). Conclusions The aims of this study were to assess comorbidities and postoperative complications in patients with esophageal cancer and to design a nomogram for the prediction of long-term survival in patients with ESCC. To the best of the knowledge of the authors of this study, this is the first attempt to establish an ESCC nomogram based on comorbidities and postoperative complications using a relatively large cohort of patients.

scholarly journals Predicting Individual Survival after Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhiyong Zhao ◽  
Xiaolong Huang ◽  
Ting Gu ◽  
Zhu Chen ◽  
Limin Gan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Accuracy ◽  
Disease Free Survival ◽  
Chronic Obstructive ◽  
Postoperative Sepsis ◽  
T Stage ◽  
History Of

Background. Esophageal cancer is one of the leading causes of cancer-related death worldwide. Despite the significant progress in the overall treatment of esophageal cancer in recent years, the prognosis for patients who require surgery remains poor. Methods. The present study investigated the clinicopathological features of 503 patients who underwent radical esophagectomy at Huashan Hospital of Fudan University between January 2005 and January 2015. Nomograms that predicted the esophageal squamous cell carcinoma (ESCC) survival rates were established using the Cox proportional hazard regression model. Discrimination and calibration, which were calculated after bootstrapping, were used as a measure of accuracy. Results. Multivariate analyses were used to select five independent prognostic variables and build the nomogram. These variables were pathological T stage, pathological N factor, rate of positive LNs, history of chronic obstructive pulmonary disease (COPD) and postoperative sepsis. The nomogram was built to predict the rates for overall survival (OS) and disease-free survival (DFS). The concordance index for the nomogram prediction for OS and DFS was 0.720 and 0.707, respectively. Compared to the conventional TNM staging system, the nomogram had better predictive accuracy for survival (OS 0.720 vs. 0.672, P < 0.001 ; DFS 0.707 vs. 0.667; P < 0.001 ). Conclusions. The present study incorporated pathological T stage, pathological N factor, rate of positive LNs, history of COPD, and postoperative sepsis into a nomogram to predict the OS and DFS of ESCC patients. This practical system may help clinicians in both decision-making and clinical study design. The assessment of lung function for patients with COPD preoperative, and the control of disease progression are needed. Furthermore, the postoperative infection of patients should be controlled. Further studies may help to extend the validation of this method and improve the model through parameter optimization.

Evaluation of Definitive Chemoradiotherapy Versus Radical Esophagectomy in Clinical T1bN0M0 Esophageal Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Ryoma Haneda ◽  
Eisuke Booka ◽  
Kenjiro Ishii ◽  
Hirotoshi Kikuchi ◽  
Yoshihiro Hiramatsu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Definitive Chemoradiotherapy ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
Promising Alternative ◽  
Significant Difference

Abstract Background: The standard treatment for patients with clinical T1bN0M0 esophageal squamous cell carcinoma is radical esophagectomy. Definitive chemoradiotherapy is regarded as a treatment option, and good clinical outcome of this treatment has been reported. This study compared the efficacy of definitive chemoradiotherapy with radical esophagectomy.Methods: From January 2011 to December 2019, this study enrolled 68 consecutive patients. Patients were classified into two groups whether treated by surgery or definitive chemoradiotherapy. Survival outcome were compared and subsequent therapies after recurrence were also investigated.Results: Surgery was performed to 39 patients, and 29 patients received definitive chemoradiotherapy. No significant difference was noted in overall survival between two groups. However, the rate of 5-year recurrence free survival was significantly lower in definitive chemoradiotherapy group than that of surgery group (91.1% vs. 62.7%, Hazard ratio 3.976, 95% Confidence interval 1.076-14.696, p = 0.039). Patients who had local recurrence after definitive chemoradiotherapy received endoscopic submucosal dissection or photodynamic therapy as salvage therapies, and resulted in no disease progression and a good prognosis.Conclusions: Definitive chemoradiotherapy may become a promising alternative therapy comparable with radical esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma. Early detection of recurrence by frequent follow-up after definitive chemoradiotherapy is important to control disease within local recurrence, and salvage therapy for local lesions could contribute to long-term survival.

Effect of lymph node harvest for squamous cell cancer of the esophagus on survival.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 102-102
Author(s):  
Jeremiah Lee Deneve ◽  
Jill M. Weber ◽  
Sarah E. Hoffe ◽  
Ravi Sridhar ◽  
Khaldoun Almhanna ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Pathologic Response ◽  
Carcinoma Of The Esophagus ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

102 Background: The optimal number of lymph nodes harvested remains controversial in patients with esophageal cancer. Pathologic response to neoadjuvant therapy (NT) has demonstrated improved survival. However, little is known regarding the impact of NT or nodal harvest in patients with squamous cell carcinoma (SCC) of the esophagus. We examined the extent of LN harvest and outcome in patients who underwent esophagectomy for SCC. Methods: After IRB approval, using a comprehensive esophageal cancer database we identified patients who underwent esophagectomy between 1994-2011. Clinical and pathologic data were compared using Fisher’s exact and chi-square when appropriate while Kaplan-Meier estimates were utilized for survival analysis. Nodal strata were set at 12 (ST-1), 15 (ST-2), and 20 nodes (ST-3). Pathologic response to NT was defined as complete (pCR), partial (pPR), or non-response (pNR). Results: We identified 76 patients who underwent esophagectomy for SCC between 1994-2011. The median age was 62.5 years (40-85 months) with median follow up of 18.5 months (1-157 months). 48 (63%) were male and 28 (37%) were female. Twenty-eight patients (37%) underwent primary esophagectomy alone (PE) while 48 (63%) patients were treated with NT. Extent of lymphadenectomy had no significant impact on overall survival (OS) or disease free survival (DFS) for the entire cohort ST-1 p=0.8 and p=0.9, ST-2 p=0.5 and p=0.4, and ST-3 p=0.5 and 0.4, respectively. Among the patients who received NT, pCR was observed in 28 (58%), pPR in 14 (29)%, and pNR in 6 (13)%. When examining the degree of pathologic response to treatment, extent of LN harvest had no significant impact on OS or DFS for patients who underwent esophagectomy after NT (p=ns across all strata). Conclusions: The extent of LN harvest failed to demonstrate an overall or disease free survival benefit in patients with squamous cell carcinoma of the esophagus. Moreover, patients treated with NT also did not benefit from increased nodal resection irrespective of their pathologic response.

Nomogram predicting long-term survival probability of thoracic esophageal squamous cell carcinoma after radical esophagectomy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4094-4094
Author(s):  
Weimin Mao ◽  
Xinming Zhou ◽  
Qixun Chen ◽  
Youhua Jiang ◽  
Xun Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Regression Model ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Esophagectomy ◽  
Term Survival

4094 Background: Nomograms have been widely and successfully used for numerous cancers to obtain reliable prognostic information for each individual patient.To date, however, no studies have conducted survival estimates using nomograms for esophageal squamous-cell carcinoma (ESCC) in Chinese population.The purpose of this study is to develop a nomogram to predict the long-term survival probabilities in patients diagnosed with ESCC after radical esophagectomy. Methods: This study involves a dataset containing 1923 patients who underwent radical esophagectomy for ESCC at Zhejiang Cancer Hospital in Hangzhou, China. Among them, 1,578 patients with no missing data were used to build a prognostic nomogram based on Cox proportional hazard regression model. A multivariate survival analysis using Cox regression model was applied to identify significant variables with P-values <0.05. On the basis of the predictive model with the identified variables, a nomogram was constructed for predicting five-year and ten-year overall survival probabilities. The prediction model was internally validated using bootstrap resampling, assessing its optimism-corrected discrimination and calibration. Results: The median of overall survival times of 1578 ESCC patients was 35.6 months, and the 5-year and 10-year survival rate was 32% and 20%, respectively. The multivariate Cox model identified alcohol, tumor length, surgical approach, number of surgical removed lymph node, ratio of metastatic lymph nodes, region of lymph nodes dissection, depth of invasion, differentiation of tumor, postoperative complications as covariates significantly associated with survival. Across the 100 bootstrap replicates, the median optimism-corrected summary C-index for predicting survival was 0.713 (SE=0.011). Conclusions: A nomogram predicting 5- and 10-year overall survival after radical esophagectomy for ESCC in Chinese population was constructed and validated based on nine significant variables. The nomogram can be applied in daily clinical practice for individualized survival prediction of ESCC patients after potentially curative esophagectomy.

Radical esophagectomy for thoracic esophageal squamous cell carcinoma followed by adjuvant radiotherapy with or without chemotherapy: Which is more beneficial?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15597-e15597
Author(s):  
Yan Tu ◽  
Feng Peng
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adjuvant Radiotherapy ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Radical Esophagectomy ◽  
Cancer Network ◽  
Toxic Reactions

e15597 Background: The current guidelines of the National Comprehensive Cancer Network for thoracic esophageal squamous cell carcinoma(TESCC) are commended no additional treatments after surgery unless the margins are positive.The optimal therapeutic options in TESCC initially treated after surgery remains controversial .This retrospective study compared the efficacy and side effect profile between postoperative adjuvant radiotherapy(RT) and chemoradiotherapy(CRT) in stage II or III TESCC patients who underwent curative esophagectomy. Methods: From January 2006 to December 2013 , 272 cases with pathological confirmed stage II or III TESCC, who had undergone complete esophagectomy, were eligible for analysis.Of these patients, 148 cases received postoperative CRT–at least 2 courses of cisplatin plus fluorouracil or paclitaxel– while the other 124 cases received RT(≥45Gy) alone.The primary end point was overall survival (OS) and the secondary endpoint were disease free survival (DFS) and toxic reactions. Results: In CRT and RTgroups,the OS rates at 1, 3 and 5 years were 91.8% vs 83.8% , 51.3% vs 31.5% and 25% vs 9.68% , respectively(P < 0.01).In CRT and RTgroups, the median OS were 39 months (95% CI, 31.6 to 46.3 months) and 30 months (95% CI, 21.0 to 38.9 months), respectively(P = 0.213), and the median DFS were 23 months (95% CI, 14.7 to 31.3 months) and 16 months (95% CI, 13.3 to 18.6 months),respectively(P = 0.155). Univariate and multivariate analyses showed stage, N stage and the number of lymph nodes removed were independent prognostic factors for OS. There were no statistically differences between the two groups for both recurrence and metastasis rates(P > 0.05). Toxic reactions, including myelosuppression and gastrointestinal reaction, were significantly more common in the CRT group than in the RT group (P < 0.05). No significant differences in incidence of other toxic reactions were found between the two groups. Conclusions: Our results indicate that, in stage II or III TESCC patients, compared with postoperative RT,CRT has a tendency to improve survival. Toxic reactions were more common with CRT than with RT alone, but patients could tolerate CRT.

scholarly journals The Impact of Anastomosis Location in Patients with Lower Thoracic Esophageal Squamous Cell Carcinoma: A Retrospective Observational Study

2021 ◽  
Author(s):  
Wenyu Zhai ◽  
Shenshen Fu ◽  
Xiaoqiang Li ◽  
Fangfang Duan ◽  
Hongying Liao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Anastomosis Group ◽  
Prognostic Impact ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
Significant Difference ◽  
The Impact

Abstract BackgroundSeveral kinds of anastomoses with varying locations that can be performed after the surgical resection of lower thoracic esophageal squamous cell carcinoma. In this study, we evaluated the prognostic impact of anastomosis locations in these patients who underwent radical esophagectomy.MethodsLower thoracic esophageal squamous cell carcinoma patients which underwent radical esophagectomy and confirmed as microscopically complete resection were retrospectively enrolled. Anastomoses below the aortic arch or below the azygos arch were defined as low anastomosis. Other anastomoses were defined as high anastomosis. Overall survival of these two kinds of anastomoses were analyzed using the log-rank test and Cox regression model.ResultsOf the 781 patients enrolled, 196 and 585 were classified as the low anastomosis and high anastomosis groups, respectively. Overall, the survival time in low anastomosis group (median OS, 36.1 versus 65.4; P=0.01) was shorter than high anastomosis group but no statistical difference was observed in multivariate analysis (P=0.195). Again, no significant difference in survival between low anastomosis and high anastomosis group (median OS, 140.9 versus 124.8; P=0.345) were observed in pT1-T2 subgroup. In pT3-T4 subgroups, patients with low anastomosis group had significantly poorer survival that those with high anastomosis (median OS, 27.1 versus 42.9, P=0.003), even after controlling for other confounders (P=0.026). Notably, the impact of anastomosis location on long-term survival in pT3-4 patients was not significantly modified by nodal status. The internal validation of patients undergoing Sweet approach shown that pT3-T4 patients with high anastomosis had survival advantages (adjusted HR=0.711, 95%CI, 0.601 0.990, P=0.041)ConclusionsFor lower thoracic esophageal squamous cell carcinoma with declared T3-4 status, low anastomosis is associated with worse prognosis and should be avoided.

Primary squamous cell carcinoma of the ampulla of Vater: management and review of the literature

2021 ◽  
Vol 14 (1) ◽  
pp. e236477
Author(s):  
Subhash Soni ◽  
Poonam Elhence ◽  
Vaibhav Kumar Varshney ◽  
Sunita Suman
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Survival Rates ◽  
Ampulla Of Vater ◽  
Metallic Stent ◽  
Biological Behaviour ◽  
Curative Intent ◽  
Term Survival ◽  
History Of

Squamous cell carcinoma (SCC) of the ampulla of Vater is a rare pathology and only few cases are reported in the literature. With limited experience of primary SCC in the ampulla of Vater, its biological behaviour, prognosis and long-term survival rates are not well known. A 38-year-old woman presented with a history of painless progressive jaundice for which self-expending metallic stent was placed 3 years back. She was evaluated and initially diagnosed as probably periampullary adenocarcinoma. She underwent pancreaticoduodenectomy and histopathology with immunohistochemistry was suggestive of SCC of ampulla of Vater. She received adjuvant chemotherapy and doing well with no recurrence after 1 year of follow-up. In conclusion, SCC of the ampulla is an unusual pathology that should be kept as a differential diagnosis for periampullary tumours. Surgical treatment with curative intent should be performed whenever feasible even in the setting of bulky tumour to improve the outcome.

scholarly journals Survivin in esophageal cancer: An accurate prognostic marker for squamous cell carcinoma but not adenocarcinoma

2006 ◽  
Vol 119 (7) ◽  
pp. 1717-1722 ◽  
Author(s):  
Antonio Rosato ◽  
Michela Pivetta ◽  
Anna Parenti ◽  
Gaetano A. Iaderosa ◽  
Alessia Zoso ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Prognostic Marker ◽  
Squamous Cell
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