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- Title
Clinicopathological Characteristics and Survival Outcomes in Patients with Advanced Esophageal Squamous Cell Carcinoma Who Were Intraoperatively Diagnosed Non-Curative.
- Authors
Sugase, Takahito; Kanemura, Takashi; Takeoka, Tomohira; Sugimura, Keijiro; Yamamoto, Masaaki; Shinno, Naoki; Hara, Hisashi; Omori, Takeshi; Mukai, Yosuke; Mikamori, Manabu; Hasegawa, Shinichiro; Haraguchi, Naotsugu; Akita, Hirofumi; Nishimura, Junichi; Wada, Hiroshi; Matsuda, Chu; Yasui, Masayoshi; Miyata, Hiroshi
- Abstract
Introduction: Curative esophagectomy is not always possible in patients with locally advanced esophageal cancer. However, few studies have investigated patients who underwent non-curative surgery with intraoperative judgment. This study aimed to investigate patient characteristics and clinical outcomes for patients undergoing non-curative surgery and compare them between non-resectional and non-radical surgery. Methods: Among 989 consecutive patients with thoracic esophageal squamous cell carcinoma who were preoperatively expected for curative esophagectomy, 66 who were eligible for non-curative surgery were included in this study. Results: Intraoperative diagnosis of T4b accounted for 93% of the reasons for the failure of curative surgery. In those patients, esophageal cancer locally invaded into the aortobronchial constriction (70%), trachea (25%), or pulmonary vein (5%). Lymph node metastasis mainly invaded into the trachea (50%) or bronchus (28%). The overall survival of patients with non-curative surgery was 51.5%, 25.7%, and 10.4% at 6, 12, and 24 months after surgery, respectively. Although there were no differences in preoperative patient characteristics between non-resectional and non-radical surgery, distant metastasis, especially pleural dissemination, was significantly observed in T4b patients due to esophageal cancer with non-radical surgery than those with non-resectional surgery (35% vs. 15%, p = 0.002). Even in patients with non-curative surgery, R1 resection and postoperative chemoradiotherapy were identified as independent factors for survival 1 year after surgery (p = 0.047, and 0.019). Conclusions: T4b tumor located in aortobronchial constriction or trachea/bronchus makes it difficult to diagnose whether it is resectable or unresectable. Moreover, surgical procedures and perioperative treatment were deeply associated with the clinical outcomes.
- Subjects
SQUAMOUS cell carcinoma; CANCER invasiveness; TREATMENT effectiveness; DESCRIPTIVE statistics; CHEMORADIOTHERAPY; CHI-squared test; MANN Whitney U Test; SURGICAL complications; DIGESTIVE organ surgery; METASTASIS; KAPLAN-Meier estimator; DATA analysis software; ESOPHAGEAL cancer; OVERALL survival; PROPORTIONAL hazards models
- Publication
Oncology, 2024, Vol 102, Issue 5, p339
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000533772