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Clinicopathologic Characteristics of Oligometastases from Esophageal Cancer and Long-Term Outcomes of Resection

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recurrent esophageal cancer after radical therapy usually is thought to be incurable and treated with palliative-intent systemic therapy. However, it is empirically known that surgical resection may be effective for selected patients, although no consensus exists on the efficacy of surgery for recurrent esophageal cancer. This study sought to identify a group of patients for whom surgical resection is considered effective.

Methods

The study enrolled 206 patients at a single center who had recurrence after radical therapy for esophageal cancer. Prognostic factors after recurrence were identified, and efficacy of surgery was analyzed according to whether the recurrent lesions were oligometastases (i.e., ≤ 5 lesions in a single domain) or not.

Results

In the multivariate analysis, oligometastatic presentation was the only factor associated with survival after recurrence (hazard ratio 6.29; 95% confidence interval, 4.10–9.71). The actuarial survival rates for the patients with oligometastases were 59.5% at 3 years and 51.7% at 5 years. The survival rates at 3 and 5 years were significantly higher for the patients who underwent resection (64.3% and 55.6%, respectively) than for those who did not (both 100%) and for the patients with multiple metastases (9.8% and 0%, respectively). The survival rates for the patients who had oligometastases without resection were comparably lower than for the patients with multiple metastases.

Conclusion

Oligometastatic presentation at recurrence was associated with better survival outcomes for the patients who experienced recurrence after radical treatment for esophageal cancer, and surgical resection could be a choice of treatment for this group of patients.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan

    Yu Ohkura MD, Junichi Shindoh MD, PhD & Masaki Ueno MD, PhD

  2. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Yu Ohkura MD, Junichi Shindoh MD, PhD, Masaki Ueno MD, PhD, Toshiro Iizuka MD, PhD & Harushi Udagawa MD, PhD

  3. Department of Gastroenterology, Digestive Tract Center, Toranomon Hospital Kajigaya, Kawasaki, Japan

    Toshiro Iizuka MD, PhD

  4. Department of Gastroenterological Surgery, Digestive Tract Center, Toranomon Hospital Kajigaya, Kawasaki, Japan

    Harushi Udagawa MD, PhD

Authors
  1. Yu Ohkura MD
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  2. Junichi Shindoh MD, PhD
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  3. Masaki Ueno MD, PhD
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  4. Toshiro Iizuka MD, PhD
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  5. Harushi Udagawa MD, PhD
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Correspondence to Yu Ohkura MD.

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Ohkura, Y., Shindoh, J., Ueno, M. et al. Clinicopathologic Characteristics of Oligometastases from Esophageal Cancer and Long-Term Outcomes of Resection. Ann Surg Oncol 27, 651–659 (2020). https://doi.org/10.1245/s10434-019-08175-0

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  • DOI: https://doi.org/10.1245/s10434-019-08175-0

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