Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017:2017:1657310.
doi: 10.1155/2017/1657310. Epub 2017 Jun 4.

Esophageal Cancer Metastases to Unexpected Sites: A Systematic Review

Osama Shaheen  1 , Abdulaziz Ghibour  1 , Bayan Alsaid  1   2
Affiliations
Review

Esophageal Cancer Metastases to Unexpected Sites: A Systematic Review

Osama Shaheen et al. Gastroenterol Res Pract. 2017.

Abstract

The most common pattern of esophageal cancer metastases (ECM) is to the lymph nodes, lung, liver, bones, adrenal glands, and brain. On the other hand, unexpected metastasis (UM) spread to uncommon sites has increasingly reported and consequently affected the pathway of diagnosis, staging, and management. Using the PubMed database, a systematic search of the following headings "Esophageal" and "Metastasis" or "Metastases" was performed, 10049 articles were identified, and the articles were included if they demonstrated unexpected ECM. 84% of cases were men with an average age of 60.7 years. EC was located in the lower third in 65%. Two-thirds of the UM originated from the lower esophagus, and the two major histological types were adenocarcinoma 40% and squamous cell carcinoma 60%. Metastases were disseminated toward five main anatomical sites: the head and neck (42%), thoracic (17%), abdomen and pelvis (25%), extremities (9%), and multiple skin and muscle metastases (7%). The EC metastases were found to be synchronous 42% and metachronous 58%, isolated in 53.5% and multiple in 46.5%. The overall survival rate was 10.2 months. Since distant metastases are responsible for most EC-related deaths, understanding of ECM dissemination patterns needs more extensive studies. These critical data are the cornerstone of optimal cancer approach and treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The selection process of the study.
Figure 2
Figure 2
Unexpected ECM stratification according to anatomical site spread.
Figure 3
Figure 3
Unexpected ECM trend across organs.
Figure 4
Figure 4
(a) Primary EC location influence on metastasis distribution. (b) Metastasis trend according to primary EC location.
Figure 5
Figure 5
ECM anatomic location influence on pathological rate.
Figure 6
Figure 6
Tumor stage trend upon diagnosis among different ECM anatomical locations.
Figure 7
Figure 7
(a) Cancer-metastasis onset (metachronous and synchronous) across ECM anatomical groups. (b) EC and metastasis interval (median and months).
Figure 8
Figure 8
Metastasis features (isolated versus multiple).
Figure 9
Figure 9
(a) Metastasis management. (b) Outcome and survival.
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer Statistics Center. 2017, https://cancerstatisticscenter.cancer.org.
    1. Siegel R. L., Miller K. D., Jemal A. Cancer statistics, 2016. CA: A Cancer Journal for Clinicians. 2016;66(1):7–30. doi: 10.3322/caac.21332. - DOI - PubMed
    1. Ji X., Cai J., Chen Y., Chen L. Q. Lymphatic spreading and lymphadenectomy for esophageal carcinoma. World Journal of Gastrointestinal Surgery. 2016;8(1):90–94. doi: 10.4240/wjgs.v8.i1.90. - DOI - PMC - PubMed
    1. Li C. L., Zhang F. L., Wang Y. D., et al. Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer. Oncology Letters. 2013;5(1):355–359. doi: 10.3892/ol.2012.946. - DOI - PMC - PubMed
    1. Schlottmann F., Barbetta A., Mungo B., Lidor A. O., Molena D. Identification of the lymphatic drainage pattern of esophageal cancer with near-infrared fluorescent imaging. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a. 2016;27(3):268–271. doi: 10.1089/lap.2016.0523. - DOI - PMC - PubMed

LinkOut - more resources