Esophageal stenosis as an independent factor of poor prognosis in patients with ESCC treated with definitive chemoradiotherapy

Abstract

Aim: To evaluate the clinical outcome and elucidate the prognostic factors in patients with esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (CRT). Patients: Data for patients newly diagnosed with ESCC receiving definitive CRT at our institution between 2012 and 2018 were retrospectively reviewed. Results: A total of 201 patients were included. Severe stenosis after radiotherapy was an independent factor relevant to prognosis. Maximal esophageal wall thickness, short-term responses, severe stenosis at diagnosis and a high neutrophil-to-lymphocyte ratio were independent risk factors for the occurrence of severe stenosis after radiotherapy. Conclusion: Severe stenosis after radiotherapy is a useful predictive indicator in patients with ESCC receiving definitive CRT. Further studies are needed to verify these findings.

Plain language summary

This study aimed to identify valuable factors as predictive diagnostic markers for patients diagnosed with esophageal squamous cell carcinoma receiving chemoradiotherapy. In this retrospective study with patients, we have found that severe stenosis after radiotherapy has an independent predictive value for survival. Survival was also associated with maximal esophageal wall thickness, short-term responses, severe stenosis at diagnosis and a high neutrophil-to-lymphocyte ratio. Stenosis could be used as a parameter to predict survival in esophageal squamous cell carcinoma patients after chemoradiotherapy.

Keywords::

• chemoradiotherapy
• esophageal cancer
• post-radiotherapy stenosis
• prognosis
• radiotherapy

Author contributions

Z Gui and W Hu conceived and designed this study. Q Kong, Y Xu and C Liu processed the data analysis. Z Gui wrote the article. F Wang revised the final manuscript. All the authors read and approved the final manuscript.

Acknowledgments

The authors appreciate the esophagography images provided by the Department of Medical Imaging at the First Affiliated Hospital of Anhui Medical University.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents, received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

All procedures performed in this study were approved by the Institutional Review Board of the First Affiliated Hospital of Anhui Medical University and were in accordance with the Declaration of Helsinki. Formal written informed consent was waived from all patients due to its retrospective design and all data were kept confidential.