Long-term survival after multimodality therapy including surgery for metastatic esophageal cancer

Abstract

Background and objectives: Esophageal cancer (EC) remains an aggressive disease with a poor survival. Management of metastatic EC is limited to palliative chemotherapy (CT). Scientific contributions regarding the role of surgery are scarce and controversial. We analysed outcome of surgically treated metastatic EC patients.

Methods: We retrospectively identified surgically treated metastatic EC patients from our esophagectomy database. The aim of this study was to evaluate surgical complications, pathological response, oncological outcome and mean survival of these aggressively treated stage IV cancer patients.

Results: Twelve stage IV patients with disease presentation limited to outfield lymph node (LN) and/or liver metastasis were treated with an aggressive multimodality treatment including surgery. Mean age was 58 years (75% male, 75% Adenocarcinomas). Median postoperative hospital stay was 15 d. Radiological anastomotic leakage occurred in one patient. In hospital, mortality was nil. Complete resection was achieved in all but one. Metastatic recurrence occurred in 64% of R0 resected patients. At date of censoring, after a median follow-up of 22 months, 50% of the surgical resected patients are still alive and 33% are free of disease recurrence. Kaplan–Meier curves show a possibility to long-term survival after aggressive multimodality therapy including surgery.

Conclusions: In selected metastatic EC patients, multimodality treatment including surgery has an acceptable surgical outcome with a potentially long-term survival.

Keywords:

• Stage IV esophageal cancer
• metastases
• metastases
• esophagectomy

Acknowledgements

We thank our study nurses E. Pape, S. De Groote and I. Vandenbroucke for constructing and supporting our esophageal database.

Disclosure statement

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The required ethical approval for the creation and maintenance of an observational prospective database for patients with esophageal resections was granted by the ethical committee of the Ghent university hospital, Belgium. Belgian registration number: B670201111232

Availability of data and material

All relevant data were retrieved from the database or extracted from the medical records and transferred into the research database. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

The authors declare that they have no funding for this research.