Outcome for esophageal cancer following treatment with chemotherapy and radiotherapy but not esophagectomy: Nonsurgical treatment of esophageal cancer

Abstract

Background: More than 50% of patients with esophageal cancer are not suitable for surgery. The aim of this study was to analyze the outcome of patients undergoing standard nonsurgical treatment.

Methods: Data of all patients undergoing nonsurgical treatment for esophageal cancer were identified from a prospective database.

Results: Seventy-five patients were treated for localized disease, and 52 for metastatic disease at diagnosis. Except for age, which was higher in patients without metastases, there were no significant differences between the patients with vs. without metastatic disease. Kaplan-Meier analysis showed a median survival of 10.8 months for all patients. There was a significant difference in survival (p < 0.001) between the groups with versus without metastases, with median survival in the patients without metastases 13.6 months versus 6.5 months in patients with metastases. Patients undergoing nonsurgical treatment for localized disease had a five-year survival of 12%. No significant difference between adenocarcinoma and squamous cell carcinoma was identified. Subanalysis of patients who received chemoradiotherapy revealed similar results to the overall group of patients.

Conclusion: In patients with localized disease at diagnosis, long-term survival can be achieved in some patients, whereas five-year survival is rare in patients who present with metastatic disease.

Keywords: chemoradiotherapy; esophageal cancer; metastases; nonsurgical treatment; survival.

Figure 1

Kaplan–Meier survival curve of the two groups. There was a significant difference in survival in favor of the nonmetastatic group (log rank test, p < 0.001).

Figure 2

Kaplan–Meier survival curve for the nonmetastatic group stratified by histological types. There was no significant difference in survival (log rank test, p = 0.897).

Figure 3

Kaplan–Meier survival curve for the metastatic group stratified by histological type. There was no significant difference in survival (log rank test, p = 0.429).