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The Impact of Pretreatment Esophageal Stenosis on Survival of Esophageal Cancer Patients

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

Abstract

Background

Little is known about the survival impacts of pretreatment cancerous stenosis on patients with esophageal carcinoma (EC).

Methods

The clinicopathologic characteristics of patients who underwent surgery for EC between January 2010 and December 2018 were retrospectively reviewed. Esophageal stenosis was defined as present when a thin endoscope could not be passed through the tumor site. The impacts of stenosis on overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox hazards analysis.

Results

Of the 496 EC patients in this study, 51 (10.3 %) had pretreatment esophageal stenosis. Stenosis was associated with lower body mass index (P < 0.001) and higher pStage (P < 0.001). The 3-year OS rate for the patients with stenosis was significantly poorer than for the patients without stenosis (40.2 % vs 69.6 %; hazard ratio [HR], 2.19; P < 0.001). The survival outcomes, especially CSS, for the patients with stenosis were significantly poorer than for the patients without stenosis for both pStage II-III (P = 0.009) and pStage IV (P = 0.006) disease. The OS and CSS curves were well stratified by the presence of stenosis even in early-stage (pStage II) patients (P = 0.04 and P < 0.01, respectively). Multivariable analysis showed esophageal stenosis, pStage III-IV disease, and non-curative resection to be independently associated with poor OS (HR, 1.61; P = 0.02) and poor CSS (HR,1.67; P = 0.02). Higher pStage was an independent predictor of poor CSS for patients without stenosis, but not for those with stenosis.

Conclusions

Esophageal carcinoma patients with pretreatment stenosis had significantly poorer survival outcomes, especially poorer CSS, than those without stenosis in both early- and advanced-stage diseases.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Saitama Cancer Center Hospital, Saitama, Japan

    Kotaro Sugawara MD, PhD, Takashi Fukuda MD, Yutaka Kishimoto MD, Daiji Oka MD, PhD, Yoichi Tanaka MD & Yoshiyuki Kawashima MD, PhD

  2. Department of Gastroenterology, Saitama Cancer Center Hospital, Saitama, Japan

    Hiroki Hara MD & Takako Yoshii MD, PhD

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  1. Kotaro Sugawara MD, PhD
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10434_2022_12945_MOESM3_ESM.tiff

Fig. S1 Survival outcomes according to the presence of stenosis and Glasgow prognostic score (GPS). (a) Overall survival (OS) and (b) cancer-specific survival (CSS) curves according to the presence of stenosis and GPS. Patients with both pretreatment stenosis and high GPS had much poorer survival outcomes (median survival time (MST), 5.9 months) than those who had only one or neither of these factors (P < 0.01).

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Sugawara, K., Fukuda, T., Kishimoto, Y. et al. The Impact of Pretreatment Esophageal Stenosis on Survival of Esophageal Cancer Patients. Ann Surg Oncol 30, 2703–2712 (2023). https://doi.org/10.1245/s10434-022-12945-8

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