Clinical implications of endoscopic ultrasonography non-traversability in patients with locoregional esophageal cancer receiving multimodality therapy.
- Author:
Charles J CHO
1
;
Ho June SONG
;
Gin Hyug LEE
;
Kee Don CHOI
;
Yong Hee KIM
;
Jin Sook RYU
;
Sung Bae KIM
;
Jong Hoon KIM
;
Seung Il PARK
;
Hwoon Yong JUNG
Author Information
- Publication Type:Original Article
- Keywords: Esophageal neoplasms; Carcinoma, squamous cell; Malignant stricture; Endosonography; Prognosis
- MeSH: Carcinoma, Squamous Cell; Chemoradiotherapy; Constriction, Pathologic; Endosonography*; Esophageal Neoplasms*; Esophagectomy; Humans; Multivariate Analysis; Prognosis; Retrospective Studies; Serum Albumin; Weight Loss
- From:The Korean Journal of Internal Medicine 2017;32(3):443-451
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Approximately 30% of esophageal cancer (EC) patients cannot complete endoscopic ultrasonography (EUS) due to malignant stricture (EUS non-traversability). This study examines clinical implications of EUS non-traversability in patients with advanced locoregional squamous EC receiving preoperative chemoradiotherapy (CRT) followed by esophagectomy. METHODS: We retrieved data on 89 consecutive patients with advanced locoregional squamous EC (stage II or III). Relevant clinical and tumor-specific parameters were reviewed retrospectively. Significant factors affecting survival was determined by Cox regression analysis. RESULTS: EUS non-traversable EC was observed in 26 of 89 patients (29.2%). Median serum albumin level (3.6 g/dL vs. 3.9 g/dL, p = 0.028), tumor length (6.0 cm vs. 4.0 cm, p = 0.002), and percentage of clinical stage III disease (65.4% vs. 38.1%, p = 0.019) were significantly different between the patients with EUS non-traversable and traversable EC, respectively. Patients with EUS non-traversable EC demonstrated a significantly lower 5-year overall survival than patients with EUS traversable EC (30.8% vs. 49.3%, p = 0.023). In multivariate analysis, weight loss ≥ 10% (p = 0.033), EUS non-traversability (p = 0.003), non-response to preoperative CRT (p = 0.002), and incompletion of esophagectomy (p = 0.002) were significant negative factors of survival. CONCLUSIONS: EUS non-traversability has significant negative prognostic implications in patients with advanced locoregional squamous EC receiving preoperative CRT followed by esophagectomy.
