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Erschienen in: Annals of Surgical Oncology 11/2018

26.07.2018 | Thoracic Oncology

Long-Term Outcome of Definitive Chemoradiotherapy and Induction Chemoradiotherapy Followed by Surgery for T4 Esophageal Cancer with Tracheobronchial Invasion

verfasst von: Shohei Yamaguchi, MD, PhD, Masaru Morita, MD, PhD, Manabu Yamamoto, MD, PhD, Akinori Egashira, MD, PhD, Hiroyuki Kawano, MD, PhD, Nao Kinjo, MD, PhD, Eiji Tsujita, MD, PhD, Kazuhito Minami, MD, PhD, Masahiko Ikebe, MD, PhD, Yasuharu Ikeda, MD, PhD, Naonobu Kunitake, MD, Yasushi Toh, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 11/2018

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Abstract

Background

T4 esophageal cancer (EC) that invades the trachea or bronchus often has poorer prognosis than other T4 ECs. We investigated the long-term results of definitive chemoradiotherapy (dCRT) or induction chemoradiotherapy followed by surgery (iCRT-S) in patients with T4 EC with tracheobronchial invasion (TBI).

Patients and Methods

From 2003 to 2013, 71 patients with T4 EC with TBI were treated in our institution; 58 underwent dCRT, and 13 underwent iCRT-S. The long-term results associated with survival were retrospectively analyzed, and prognostic factors were examined by univariable and multivariable analysis.

Results

The 1-, 2-, and 5-year overall survival for all patients with T4 EC with TBI treated by dCRT or iCRT-S was 57, 29, and 19%, respectively. Multivariable analysis revealed that clinical lymph node (LN) metastasis and the treatment period were significant prognostic factors. Clinical LN positivity had significantly poorer prognosis than LN negativity. The treatment outcome in the later period was significantly better than that in the earlier period. In particular, the outcome after dCRT revealed significantly better prognosis in the later compared with the earlier period, whereas the outcome after iCRT-S did not show such a difference. With respect to treatment modality, no significant difference in survival was observed between dCRT and iCRT-S.

Conclusions

Clinical LN negativity and later treatment period were significantly good prognostic factors for T4 EC with TBI. The recent improvements in dCRT outcomes may help to achieve survival comparable to that of iCRT-S.
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Metadaten
Titel
Long-Term Outcome of Definitive Chemoradiotherapy and Induction Chemoradiotherapy Followed by Surgery for T4 Esophageal Cancer with Tracheobronchial Invasion
verfasst von
Shohei Yamaguchi, MD, PhD
Masaru Morita, MD, PhD
Manabu Yamamoto, MD, PhD
Akinori Egashira, MD, PhD
Hiroyuki Kawano, MD, PhD
Nao Kinjo, MD, PhD
Eiji Tsujita, MD, PhD
Kazuhito Minami, MD, PhD
Masahiko Ikebe, MD, PhD
Yasuharu Ikeda, MD, PhD
Naonobu Kunitake, MD
Yasushi Toh, MD, PhD
Publikationsdatum
26.07.2018
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 11/2018
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6656-6

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