International Journal of Clinical Oncology

, Volume 21, Issue 5, pp 899–908 | Cite as

Identification of a predictive factor for distant metastasis in esophageal squamous cell carcinoma after definitive chemoradiotherapy

  • Katsuyuki Sakanaka
  • Yuichi Ishida
  • Satoshi Itasaka
  • Yasumasa Ezoe
  • Ikuo Aoyama
  • Shinichi Miyamoto
  • Takahiro Horimatsu
  • Manabu Muto
  • Masahiro Hiraoka
Original Article
First Online:
Received:
Accepted:

Abstract

Background and purpose

Distant metastasis (DM) after definitive chemoradiotherapy has not been a focus of research in esophageal carcinoma. At present, local–regional control is improving following advances in salvage treatments after definitive chemoradiotherapy. There is a need to focus on suppressing the development of DM. The aim of this study was to identify pre-treatment factors associated with DM after definitive chemoradiotherapy.

Materials and methods

This study included 144 patients with thoracic esophageal squamous cell carcinoma (Stage I/II/III/IV; 35/17/69/23) (TNM 7th) who underwent definitive chemoradiotherapy; >50 Gy was prescribed to all gross tumors with concurrent administration of 5-fluorouracil ± platinum. Pre-treatment factors included age, gender, performance status, tumor location, T/N/M status, tumor length, size of metastatic lymph nodes (LN size), and the presence of intramural metastasis or multiple primary tumors. The effects of pre-treatment factors on overall survival (OS) and DM were evaluated.

Results

The median follow-up period was 48 months. DM occurred as an initial progression in 21 % of patients, and LN size correlated with DM development (hazard ratio [HR] = 5.12; p = 0.0013) and poor OS (HR = 2.20; p = 0.0076) in univariate and multivariate analyses.

Conclusions

LN size is a quantitative pre-treatment prognostic factor that should be assessed prior to definitive chemoradiotherapy. Patients with large metastatic lymph nodes are at high risk of DM and should be monitored.

Keywords

Esophageal carcinoma Chemoradiotherapy Prognostic factor 
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Notes

Acknowledgments

This research was partially supported by grants from the Fujiwara Memorial Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2016

Authors and Affiliations

  • Katsuyuki Sakanaka
    • 1
  • Yuichi Ishida
    • 1
  • Satoshi Itasaka
    • 2
  • Yasumasa Ezoe
    • 3
  • Ikuo Aoyama
    • 3
  • Shinichi Miyamoto
    • 4
  • Takahiro Horimatsu
    • 3
  • Manabu Muto
    • 3
  • Masahiro Hiraoka
    • 1
  1. 1.Department of Radiation Oncology and Image-applied Therapy, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Department of Radiation OncologyKurashiki Central HospitalOkayamaJapan
  3. 3.Department of Therapeutic Oncology, Graduate School of MedicineKyoto UniversityKyotoJapan
  4. 4.Department of Gastroenterology and Hepatology, Graduate School of MedicineKyoto UniversityKyotoJapan

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