Clinicopathological features and surgical treatment of cervical oesophageal cancer

Abstract

Cervical oesophageal cancer (CEC) is a relatively uncommon malignancy. The biological behaviour and treatment have not been well studied. This retrospective study reviewed the clinicopathological features of 28 patients with CEC who underwent surgical resection to investigate the biological behaviour, treatment and prognosis of CEC. The long-term outcomes of these patients were compared with those of the CEC patients who received definitive chemoradiotherapy and those of thoracic or abdominal oesophageal cancer patients who underwent surgery. The study group contained 21 men and 7 women, ranging in age from 41 to 67 years (median: 56.5 years). The median survival time and the 1-, 3-, and 5-year overall survival rates were 25.0 months, 83.8%, 48.8%, and 41.9%, respectively. Only salvage surgery was found to affect the overall survival (P = 0.007). The long-term outcomes for CEC patients who underwent surgery were significantly better than those who received definitive chemoradiotherapy (P = 0.045) but were similar to those of thoracic or abdominal oesophageal cancer patients. In summary, CEC is an uncommon and aggressive malignancy. The malignant potential of CEC is similar to that of thoracic or abdominal oesophageal cancer. Surgical resection is an important therapeutic strategy and may be associated with better survival rates than definitive chemoradiotherapy.

Figure 1

Comparison of the survival curves for patients with cervical oesophageal cancer who underwent salvage surgery and non-salvage surgery. The MST and 5-year OS rate for patients who underwent salvage surgery were 15.0 months (95% CI 10.5–19.5) and 0%, respectively, which were significantly lower than those of 97.0 months (95% CI 0.1–193.9) and 54.0%, respectively, for patients who underwent non-salvage surgery (P = 0.007).

Figure 2

Comparisons of the survival curves for patients with cervical oesophageal cancer who received surgery and definitive chemoradiotherapy. The MST and the1-, 3-, and 5-year OS rates for patients who underwent surgery were 25.0 months (95% confidence interval (CI) 0.8–49.2 months), 83.8%, 48.8%, and 41.9%, respectively, which were significantly better compared with those of 19.0 months (95% CI 16.6–21.4 months), 67.4%, 32.5%, and 21.0%, respectively, for patients who received definitive chemoradiotherapy (P = 0.045).

Figure 3

Comparisons of the survival curves for patients with cervical oesophageal cancer and patients with thoracic or abdominal oesophageal cancer who underwent surgery. The median survival time (MST) and the1-, 3-, and 5-year OS rates for CEC patients were 25.0 months (95% confidence interval (CI) 0.8–49.2 months), 83.8%, 48.8%, and 41.9%, respectively, compared with those of 49.0 months (95% CI 43.9–54.1 months), 84.3%, 56.2%, and 46.4% for patients with thoracic or abdominal oesophageal cancer. The survival differences were not statistically significant (P = 0.429).

Figure 4

Comparisons of the survival curves for patients with cervical oesophageal cancer and patients with thoracic or abdominal oesophageal cancer who did not receive preoperative therapy. The MST and the1-, 3-, and 5-year OS rates for CEC patients were 97.0 months (95% CI 10.0–184.0 months), 93.8%, 63.9%, and 53.3%, respectively, compared with those of 50.0 months (95% CI 44.1–55.9 months), 84.3%, 56.5%, and 46.8% for patients with thoracic or abdominal oesophageal cancer. The survival differences were not significant (P = 0.748).