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Outcomes of Definitive Chemoradiotherapy for Cervical and Upper Thoracic Esophageal Cancers: a Single-Institution Experience of a Rare Cancer

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Abstract

Purpose

Upper esophageal carcinomas are uncommon but confer a poor prognosis. However, there is scarcity of data regarding outcomes of definitive chemoradiotherapy for cervical and upper thoracic esophageal squamous cell carcinoma in Iran.

Methods

In this retrospective cohort study, we analyzed data of patients with squamous cell carcinoma of cervical and upper thoracic esophagus (at 16 to 25 cm from incisors) treated by definitive chemoradiotherapy in our institution between 2007 and 2015. The primary outcome was overall survival and secondary endpoints were predictors of overall survival.

Results

From 2007 to 2015, 40 patients were entered to final analysis. The mean age of patients was 59.7 ± 14.3 (range 24–85 years). Sixteen (40%) were node-positive. The median follow-up time was 15.3 months. Twenty-seven patients (67.5%) died during post treatment period. Thirty-five percent and 25% of patients suffered from local and distant recurrences, respectively. The actuarial median overall survival was 19.2 (CI 95% 14.2–24.2) months. The 1- and 2-year overall survival rates were 76 and 38%, respectively. The overall survival was higher among patients who were younger than 50 years, of female gender, had stage II tumor, grades I to II, who received induction chemotherapy, and whom treated with doses < 60 Gy. However, none of the differences was statistically significant.

Conclusions

Cervical and upper thoracic esophageal squamous cell carcinomas are associated with bad outcome. Studies with bigger sample sizes are required to define best treatment strategies.

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Authors and Affiliations

  1. Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

    Ebrahim Esmati, Afsaneh Maddah Safaei, Reza Ghalehtaki, Negin Mohammadi & Marzieh Lashkari

  2. Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

    Nima Mousavi, Ehsan Saraee & Sepehr Shirouei

Authors
  1. Ebrahim Esmati
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  2. Afsaneh Maddah Safaei
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  3. Reza Ghalehtaki
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  4. Nima Mousavi
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  5. Ehsan Saraee
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  6. Sepehr Shirouei
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  7. Negin Mohammadi
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  8. Marzieh Lashkari
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Corresponding author

Correspondence to Reza Ghalehtaki.

Ethics declarations

Our study was reviewed and approved by the institutional review board and ethics committee to be in agreement with World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects,” amended in October 2013, (www.wma.net). Patients provide informed consent at the time of admission to our cancer institution to share their disease information for future investigations.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Esmati, E., Maddah Safaei, A., Ghalehtaki, R. et al. Outcomes of Definitive Chemoradiotherapy for Cervical and Upper Thoracic Esophageal Cancers: a Single-Institution Experience of a Rare Cancer. J Gastrointest Canc 50, 380–385 (2019). https://doi.org/10.1007/s12029-018-0081-8

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  • DOI: https://doi.org/10.1007/s12029-018-0081-8

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