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Predictors of Survival After Treatment of Oligometastases After Esophagectomy
- Source :
- The Annals of Thoracic Surgery. 105:357-362
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background Recurrent esophageal carcinoma (EC) has a dismal prognosis. However, prior studies showed that selected patients with isolated recurrence may benefit from definitive therapy. The aim of this study was to identify the predictors of postrecurrence survival (PRS) in patients with isolated EC recurrence who were treated with curative intent. Methods A retrospective review of a prospective database (1988 to 2015) was performed to identify all recurrent EC patients after curative esophagectomy. Demographic and clinicopathologic data were reviewed. The probability of PRS was estimated with the Kaplan-Meier method. Predictors of PRS after definitive therapy for isolated EC recurrence were determined by the multivariable Cox proportional hazards model. Results Of the 640 curative esophagectomies, 241 patients (37.7%) experienced recurrences (median follow-up 50 months). Fifty-six patients (9%) received definitive treatment of isolated EC recurrence (31 were treated surgically with or without chemotherapy-radiotherapy [CTRT] and 25 received definitive CTRT alone). Median time to recurrence (TTR) was 19 months. The 1- and 3-year PRSs were 78% and 38% (median survival 26 months). On multivariable analysis; TTR was the only significant independent predictor for survival after recurrence (hazards ratio 0.98, 95% confidence interval: 0.96 to 0.99, p = 0.034). No pronounced difference was found in disease-free survival or in PRS between recurrent patients treated with operation with or without CTRT and patients who received definitive CTRT. Conclusions A select subgroup of patients with isolated EC recurrence can be treated with curative intent. TTR was the best predictor for PRS.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Lung Neoplasms
Esophageal Neoplasms
medicine.medical_treatment
Recurrent Esophageal Carcinoma
New York
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Gastroenterology
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Internal medicine
Carcinoma
Humans
Medicine
Neoplasm Metastasis
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Proportional hazards model
Hazard ratio
Retrospective cohort study
Middle Aged
Prognosis
medicine.disease
Confidence interval
Esophagectomy
Survival Rate
030220 oncology & carcinogenesis
Carcinoma, Squamous Cell
Female
Surgery
Cardiology and Cardiovascular Medicine
business
After treatment
Follow-Up Studies
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....888c015d73028d303301f8495026a7e4