Local treatment options for management of loco-regional esophageal squamous cell carcinoma
In: Romanian Journal of Military Medicine, Band 122, Heft 2, S. 36-42
ISSN: 2501-2312
Aim: Surgical treatment is the main treatment method for esophageal cancer. The prognosis is poor due to high local recurrence and distant metastasis rates. Study aims to evaluate the most effective local treatment modality esophageal squamous cell carcinoma (SCC) according to real life data. Method: 136 patients were studied retrospectively. All patients were middle or lower esophageal cancer and had the SCC histology. Patients were divided into the surgical resection, definitive CRT (dCRT), and multimodal treatment groups according to curative local treatment they received. Result: 32.4% were in the surgical, 36% were in the dCRT, and 31.6% were in the multimodal group. Median disease-free survival was 21 months (95% CI 14-27) in the surgical group, 8 months (95% CI 4-11) in the dCRT group, and 18 months (95% CI 0-39) in the multimodal group (p=0.059). The median overall survival was found to be 40 months (95% CI 0-92) in the surgical group, 19 months (95% CI 15-22) in the dCRT group, and 54 months (95% CI 11-96) in the multimodal group (p=0.012). In multimodal group, the number of patients receiving preoperative CRT was 25, and postoperative CRT was 18. Median OS was 47 months (95% CI 0-99) in the preoperative CRT group, and 64 months (NA) in the postoperative CRT group (p=0.302). Conclusion: DFS and OS contributions of multimodal treatment in esophageal SCC have been shown in the present study. The addition of CRT to surgery in the preoperative or postoperative period has a contribution independently of the treatment sequence.