Document Type : Original Article(s)
Authors
- Zahra Sadin 1
- Abdolazim Sedighi Pashaki 2
- Elham Khanlarzadeh 3
- Mohammad Hadi Gholami 4
- Safoora Nikzad 5
1 Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 Departement of Radiooncology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3 Department of Community Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4 Mahdieh Radiotherapy and Brachytherapy Charitable Center, Hamadan, Iran
5 Department of Medical Physics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Background: The current study aimed to determine the trends in esophageal cancer (EC) patients and examine the impact of the type and anatomical location of the tumor and the site of metastasis on their survival.
Method: In this retrospective cohort study, we investigated 305 patients with a definite diagnoses of EC, who had been hospitalized at the Mahdie Hospital of Hamadan, Iran, during ten years from 2005-2015. EC-related survival considering different types and locations of the tumor, as well as the sites of metastasis, was evaluated. Survival was calculated using Kaplan-Meier curves and a multivariable Cox regression analysis (MVA) was performed.
Results: Squamous cell carcinoma was found in 76.6% of the patients and 23.4% had adenocarcinoma (AC). There was a significant relationship between the location and pathological type of tumor; 87% of ACs happened in the lower part of the esophagus (P = 0.015). The 1- to 5-year relative survival of the patients was 46%, 25%, 22%, 12%, and 7%, respectively. The rate of death in liver, lung, brain, pancreas, abdomen, and lymph nodes metastasis were respectively 42.9%, 21.4%, 14.3%, 7.1%, 7.1%, and 7.1%. No significant relationships were observed between the tumor type and metastasis (P = 0.14) or between the tumor type and the location of metastasis (P = 0.7).
Conclusion: Similar to other reports, the rate of survival was higher in AC type, yet the rate of total survival in Iran was much lower than that in developed countries. There were no differences in the survival rate concerning the location of the tumor. The obtained results did not show any relationships among the tumor type, the location of metastasis, and the total survival.
Keywords
How to cite this article:
Sadin Z, Sedighi Pashaki A, Khanlarzadeh E, Gholami MH, Nikzad S. Overall survival in esophageal cancer based on type, anatomical location, and site of metastasis. Middle East J Cancer. 2022;13(4):674-83 doi: 10.30476/mejc.2021. 89541.1531.
2. Yarhoseini A, Shrifzadeh L, Sayehmir, Kourosh, Mortazavi- Tabatabae SAR. Survival rates for esophageal carcinoms in Iran: a systematic review and meta-analysis. Iran J Cancer Prev. 2014;7(2):61-5.
3. Zhang Z, Chen Y, Chen Y, Jeter M, Hofstetter WL, Ajani J, et al. Outcomes with esophageal cancer radiation therapy. J Thorac Oncol. 2009;4: 880-8. doi: 10.1097/JTO.0b013e3181a6f204
4. Wu SG, Zhang WW, Sun JY, Li FY, Lin Q, He ZY. Patterns of distant metastasis between histological types in esophageal cancer. Front Oncol. 2018;8. doi: 10.3389/fonc.2018.00302.
5. Kim KH, Chang JS, Cha JH, Lee IJ, Kim DJ, Cho BC, et al. Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma: A radiotherapy perspective. Cancer Res Treat. 2017;49(1):168-77. doi: 10.4143/crt.2016.142.
6. Herrmann E, Mertineit N, De Bari B, Hoeng L, Caparrotti F, Jumeau R, et al. Outcome of proximal esophageal cancer after definitive combined chemoradiation: A multicenter retrospective study. Radiat Oncol. 2017; 12, 97. doi:10.1186/s13014-017-0834-8.
7. Carstens H, Albertsson M, Friesland S, Adell G, Frykholm G, Wagenius G, et al. A randomized trial of chemoradiotherapy versus surgery alone in patients with resectable esophageal cancer. J Clin Oncol. 2007;25(18_suppl):4530. doi: 10.1200/jco. 2007.25.18_suppl.4530
8. Bashash M, Shah A, Hislop G, Brooks-Wilson A, Le N, Bajdik C. Incidence and survival for gastric and esophageal cancer diagnosed in British Columbia, 1990 to 1999. Can J Gastroenterol. 2008;22:143-8. doi: 10.1155/2008/645107.
9. Eloubeidi MA, Desmond R, Arguedas M R, Reed CE, Wilcox CM. Prognostic factors for the survival of patients with esophageal carcinoma in the U.S.: the importance of tumor length and lymph node status. Cancer. 2002; 95(7):1434-43. doi:10.1002/cncr.10868.
10. Li H, Zhang Q, Xu L, Chen Y, Wei Y, Zhou G. Factors predictive of prognosis after esophagectomy for squamous cell cancer. J Thorac Cardiovasc Surg. 2009;137(1):55-9. doi: 10.1016/j.jtcvs.2008.05.024.
11. Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97:142-6. doi: 10.1093/jnci/dji024.
12. Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst. 2008;100:1184-7. doi: 10.1093/jnci/djn211.
13. Bosch A, Frias Z, Caldwell WL, Jaeschke WH. Autopsy findings in carcinoma of the esophagus. Acta Radiol Oncol Radiat Phys Biol. 1979;18(2):103-12. doi: 10.3109/02841867909128196.
14. Chen MQ, Xu BH, Zhang YY. Analysis of prognostic factors for esophageal squamous cell carcinoma with distant organ metastasis at initial diagnosis. J Chin Med Assoc. 2014;77(11):562-6. doi: 10.1016/j. jcma.2014.05.014.
15. Tustumi F, Kimura CM, Takeda FR, Sallum RA, Ribeiro-Junior U, Cecconello I. Evaluation of lymphatic spread, visceral metastasis and tumoral local invasion in esophageal carcinomas. Arq Bras Cir Dig. 2016;29(4):215-7. doi: 10.1590/0102-672020160004000.
16. Samadi F, Babaei M, Yazdanbod A, Fallah M, Nouraie M, Nasrollahzadeh D, et al. Survival rate of gastric and esophageal cancers in Ardabil province, North-West of Iran. Arch Iran Med. 2007;10:32-7.
17. Ghadimi MR, Mahmoodi M, Mohammad K, Rasouli M, Zeraati H, Fotouhi A. Factors affecting survival of patients with oesophageal cancer: a study using inverse Gaussian frailty models. Singapore Med J. 2012;53:336-43.
18. Ravikanth R. Esophageal carcinoma causing cystic metastases of liver. Digital Medicine. 2017;3(3):145-6. doi: 10.4103/2226-8561.220129.
19. Kesler KA, Hammoud ZT, Helft PR, Rieger KM, Pritz MB, Brown JW. Long-term survival after excision of a solitary esophageal cancer brain metastasis. J Thorac Cardiovasc Surg. 2006;131(2):497-8. doi: 10.1016/j. jtcvs.2005.09.041.
20. Wu SG, Zhang WW, He ZY, Sun JY, Chen YX, Guo L. Sites of metastasis and overall survival in esophageal cancer: a population-based study. Cancer Manag Res. 2017;9:781-8. doi: 10.2147/CMAR.S150350.
21. Amin RN, Parikh SJ, Gangireddy VG, Kanneganti P, Talla S, Daram S. Early esophageal cancer specific survival is unaffected by anatomical location of tumor: A population-based study. Can J Gastroenterol Hepatol. 2016;2016:6132640. doi: 10.1155/2016/ 6132640.
22. Nassri A, Zhu H, Muftah M, Ramzan Z. Epidemiology and survival of esophageal cancer patients in an American cohort. Cureus. 2018;10(4). doi:10.7759 /cureus.2507.
23. Jung HK, Tae CH, Lee HA, Lee H, Don Choi K, Park JC, et al. Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. PLoS One. 2020;15(4):e0231456. doi: 10.1371/ journal.pone.0231456.
24. Delpisheh A, Veisani Y, Sayehmiri K, Rahimi E. Esophageal carcinoma: long-term survival in consecutive series of patients through a retrospective cohort study. J Gastroenterol Hepatol. 2014;7(2):101-7.
25. Azami A, Yazdanbod A, Abbasgholizadeh N, Sadeghi Y. Esophagus cancer risk factors in relation with different anatomical sites of esophagus in Aras GI clinical, Ardabil. [In Persian] J Ardabil Univ Med Sci. 2005;6(2): 126-31.
26. Brown LM, Devesa SS. Epidemiologic trends in esophageal and gastric cancer in the United States. Surg Oncol Clin N Am. 2002;11:235-56. doi: 10.1016/s1055-3207(02)00002-9.
27. Moghimi Dehkordi B, Rajaiifard A, Safaii A, Tabatabai H, Zeighami B, Tabei SZ. Application of life chart in estimating life expectancy and its effective factors in esophageal cancer. [In Persian] J Adv Med Biomed Res. 2008;16(63):67-74.
28. Bashash M, Yavari P, Hislop TG, Shah A, Sajadi A, Babaei M, et al. Comparison of two diverse populations, British Columbia, Canada, and Ardabil, Iran, indicates several variables associated with gastric and esophageal cancer survival. J Gastrointest Canc. 2011;42:40-5. doi: 10.1007/s12029-010-9228-y.
29. Tanaka T, Fujita H, Matono S, Nagano T, Nishimura K, Murata K, et. al. Outcomes of multimodality therapy for stage IVB esophageal cancer with distant organ metastasis. Dis Esophagus. 2010;23(8):646-51. doi: 10.1111/j.1442-2050.2010.01069.x.
30. Blank S, Lordick F, Dobritz M, Grenacher L, Burian M, Langer R, et al. A reliable risk score for stage IV esophagogastric cancer. Eur J Surg Oncol. 2013;39(8):823-30. doi:10.1016/j.ejso.2013.01.005.
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