TY - JOUR
T1 - The impact of histology on recurrence patterns in esophageal cancer treated with definitive chemoradiotherapy
AU - Xi, Mian
AU - Xu, Cai
AU - Liao, Zhongxing
AU - Hofstetter, Wayne L.
AU - Blum Murphy, Mariela
AU - Maru, Dipen M.
AU - Bhutani, Manoop S.
AU - Lee, Jeffrey H.
AU - Weston, Brian
AU - Komaki, Ritsuko
AU - Lin, Steven H.
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/8
Y1 - 2017/8
N2 - Background To assess the impact of histology on recurrence patterns and survival outcomes in patients with esophageal cancer (EC) treated with definitive chemoradiotherapy (CRT). Methods We analyzed 590 consecutive EC patients who received definitive CRT from 1998 to 2014, including 182 patients (30.8%) with squamous cell carcinoma (SCC) and 408 (69.2%) with adenocarcinoma. Recurrence pattern and timing, survival, and potential prognostic factors were compared. Results After a median follow-up time of 58.0 months, the SCC group demonstrated a comparable locoregional recurrence rate (42.9% vs. 38.0%, P = 0.264) but a significantly lower distant failure rate (27.5% vs. 48.0%, P < 0.001) than adenocarcinoma group. No significant difference was found in overall survival or locoregional failure-free survival between groups, whereas the SCC group was associated with significantly more favorable recurrence-free survival (P = 0.009) and distant metastasis-free survival (P < 0.001). The adenocarcinoma group had higher hematogenous metastasis rates of bone, brain, and liver, whereas the SCC group had a marginally higher regional recurrence rate. Among patients who received salvage surgery after locoregional recurrence, no significant difference in survival was found between groups (P = 0.12). Conclusions The patterns and sites of recurrence, survival outcomes, and prognostic factors were significantly different between esophageal SCC and adenocarcinoma.
AB - Background To assess the impact of histology on recurrence patterns and survival outcomes in patients with esophageal cancer (EC) treated with definitive chemoradiotherapy (CRT). Methods We analyzed 590 consecutive EC patients who received definitive CRT from 1998 to 2014, including 182 patients (30.8%) with squamous cell carcinoma (SCC) and 408 (69.2%) with adenocarcinoma. Recurrence pattern and timing, survival, and potential prognostic factors were compared. Results After a median follow-up time of 58.0 months, the SCC group demonstrated a comparable locoregional recurrence rate (42.9% vs. 38.0%, P = 0.264) but a significantly lower distant failure rate (27.5% vs. 48.0%, P < 0.001) than adenocarcinoma group. No significant difference was found in overall survival or locoregional failure-free survival between groups, whereas the SCC group was associated with significantly more favorable recurrence-free survival (P = 0.009) and distant metastasis-free survival (P < 0.001). The adenocarcinoma group had higher hematogenous metastasis rates of bone, brain, and liver, whereas the SCC group had a marginally higher regional recurrence rate. Among patients who received salvage surgery after locoregional recurrence, no significant difference in survival was found between groups (P = 0.12). Conclusions The patterns and sites of recurrence, survival outcomes, and prognostic factors were significantly different between esophageal SCC and adenocarcinoma.
KW - Definitive chemoradiotherapy
KW - Esophageal cancer
KW - Histology
KW - Recurrence
KW - Survival
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U2 - 10.1016/j.radonc.2017.06.019
DO - 10.1016/j.radonc.2017.06.019
M3 - Article
C2 - 28687396
AN - SCOPUS:85021701824
SN - 0167-8140
VL - 124
SP - 318
EP - 324
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -