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Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer
by
Gasparri, Mario
, Johnstone, David
, Johnstone, Candice
, Matoska, Thomas
, Linsky, Paul
, George, Ben
, Banerjee, Anjishnu
, Shreenivas, Aditya
, Puckett, Lindsay L.
, Gore, Elizabeth M.
, Jurkowski, Lauren
, Shukla, Monica E.
in
Cancer
/ Cancer patients
/ Cancer therapies
/ Care and treatment
/ Chemoradiotherapy
/ Chemotherapy
/ Development and progression
/ Electronic health records
/ Esophageal cancer
/ Esophagus
/ Histology
/ Lymphatic system
/ Medical prognosis
/ Medical records
/ Metastases
/ Metastasis
/ Oncology, Experimental
/ Palliation
/ Patient outcomes
/ Patients
/ Radiation
/ Radiation therapy
/ Radiotherapy
/ Survival
/ Survival analysis
/ Variables
2023
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Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer
by
Gasparri, Mario
, Johnstone, David
, Johnstone, Candice
, Matoska, Thomas
, Linsky, Paul
, George, Ben
, Banerjee, Anjishnu
, Shreenivas, Aditya
, Puckett, Lindsay L.
, Gore, Elizabeth M.
, Jurkowski, Lauren
, Shukla, Monica E.
in
Cancer
/ Cancer patients
/ Cancer therapies
/ Care and treatment
/ Chemoradiotherapy
/ Chemotherapy
/ Development and progression
/ Electronic health records
/ Esophageal cancer
/ Esophagus
/ Histology
/ Lymphatic system
/ Medical prognosis
/ Medical records
/ Metastases
/ Metastasis
/ Oncology, Experimental
/ Palliation
/ Patient outcomes
/ Patients
/ Radiation
/ Radiation therapy
/ Radiotherapy
/ Survival
/ Survival analysis
/ Variables
2023
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Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer
by
Gasparri, Mario
, Johnstone, David
, Johnstone, Candice
, Matoska, Thomas
, Linsky, Paul
, George, Ben
, Banerjee, Anjishnu
, Shreenivas, Aditya
, Puckett, Lindsay L.
, Gore, Elizabeth M.
, Jurkowski, Lauren
, Shukla, Monica E.
in
Cancer
/ Cancer patients
/ Cancer therapies
/ Care and treatment
/ Chemoradiotherapy
/ Chemotherapy
/ Development and progression
/ Electronic health records
/ Esophageal cancer
/ Esophagus
/ Histology
/ Lymphatic system
/ Medical prognosis
/ Medical records
/ Metastases
/ Metastasis
/ Oncology, Experimental
/ Palliation
/ Patient outcomes
/ Patients
/ Radiation
/ Radiation therapy
/ Radiotherapy
/ Survival
/ Survival analysis
/ Variables
2023
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Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer
Journal Article
Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer
2023
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Overview
Background: The study of oligometastatic esophageal cancer (EC) is relatively new. Preliminary data suggests that more aggressive treatment regimens in select patients may improve survival rates in oligometastatic EC. However, the consensus recommends palliative treatment. We hypothesized that oligometastatic esophageal cancer patients treated with a definitive approach (chemoradiotherapy [CRT]) would have improved overall survival (OS) compared to those treated with a purely palliative intent and historical controls. Methods: Patients diagnosed with synchronous oligometastatic (any histology, ≤5 metastatic foci) esophageal cancer treated in a single academic hospital were retrospectively analyzed and divided into definitive and palliative treatment groups. Definitive CRT was defined as radiation therapy to the primary site with ≥40 Gy and ≥2 cycles of chemotherapy. Results: Of 78 Stage IVB (AJCC 8th ed.) patients, 36 met the pre-specified oligometastatic definition. Of these, 19 received definitive CRT, and 17 received palliative treatment. With a median follow-up of 16.5 months (Range: 2.3–95.0 months), median OS for definitive CRT and palliative groups were 90.2 and 8.1 months (p < 0.01), translating into 5-year OS of 50.5% (95%CI: 32.0–79.8%) vs. 7.5% (95%CI: 1.7–48.9%), respectively. Conclusions: Oligometastatic EC patients treated with definitive CRT benefited from that approach with survival rates (50.5%) that vastly exceeded historical standards of 5% at 5 years for metastatic EC. Oligometastatic EC patients treated with definitive CRT had significantly improved OS compared to those treated with palliative-only intent within our cohort. Notably, definitively treated patients were generally younger and with better performance status versus those palliatively treated. Further prospective evaluation of definitive CRT for oligometastatic EC is warranted.
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