Abstract:
BACKGROUND:Patients with localized esophageal and esophagogastric junction cancer (EAC) receive chemoradiation and then surgery (trimodality, TMT) or definitive chemoradiation (bimodality, BMT). Distant metastases (DMs) are common but the details of their distribution and timing in a large cohort have not been described. METHODS:629 patients with localized EAC who had TMT or BMT were analyzed. Standard statistical methods were used to define the end points. RESULTS:The median follow-up time was 37.2 months (interquartile range 17.8-65.0). Of 356 TMT patients, 33% (119) developed DM as their first relapse and of 273 BMT patients, 40% (109) developed DM; 91% (TMT) and 96% (BMT) of the DMs were diagnosed within 2 years of local therapy. The most common sites of DM were: lung, distant nodes, liver, peritoneal cavity, bone, brain and pleura in order of frequency. The median overall survival of TMT patients with DM was 10.2 months (95% CI 7.8-12.7) and that for BMT patients with DM was 7.8 months (95% CI 5.7-9.9). CONCLUSIONS:Following TMT or BMT, ≥33% of patients developed DMs and most of these occurred within 2 years (>90%) of local therapy. A clinical model is desirable that associates clinical parameters with a high risk for DM in TMT-eligible patients prior to surgery.
journal_name
Oncologyjournal_title
Oncologyauthors
Shiozaki H,Sudo K,Xiao L,Wadhwa R,Elimova E,Hofstetter WL,Skinner HD,Lee JH,Weston B,Bhutani MS,Blum MA,Maru DM,Ajani JAdoi
10.1159/000360703subject
Has Abstractpub_date
2014-01-01 00:00:00pages
336-9issue
5-6eissn
0030-2414issn
1423-0232pii
000360703journal_volume
86pub_type
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