Outcomes of patients with clinical stage IV esophageal squamous cell carcinoma treated initially with definitive chemoradiotherapy: a single-institution observational study and literature review.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-07-04 DOI:10.1007/s00595-025-03087-x

Kotaro Sugawara, Koichi Yagi, Shoh Yajima, Yoshiyuki Miwa, Shuichiro Oya, Asami Okamoto, Raito Asaoka, Hideomi Yamashita, Yoshifumi Baba

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引用次数: 0

Abstract

Purpose: To investigate the long-term outcomes of patients with cStage IV esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (dCRT) and the impacts of this treatment on inflammatory and nutrition markers.

Methods: The subjects of this study were 84 patients who underwent initial dCRT for cStage IV (cT4 and/or cM1 according to eighth UICC staging system) esophageal squamous cell carcinoma (ESCC). Survival outcomes were investigated according to treatment modalities. Various inflammatory and nutrition markers, such as the C-reactive protein (CRP)-to-albumin ratio (CAR) and the lymphocyte-to-CRP ratio (LCR), were evaluated.

Results: The 3-year overall survival (OS) rate of the 84 patients was 45.8%. Clinical complete response (CR) to dCRT was achieved in 30 patients (dCRT-CR group). Salvage surgery was performed for 35 patients and curative (R0) resection was achieved in 28 patients (surg-R0 group). Patients in the surg-R0 group exhibited comparable 3-year OS (60.7%) to patients in the dCRT-CR group (60.0%). CRP-derived markers (LCR and CAR) were significantly associated with the response to dCRT (both P < 0.01) and OS (both P < 0.01).

Conclusions: Definitive chemoradiotherapy is appropriate for patients with cStage IV ESCC. Curative salvage surgery provides survival benefits for the tumor entity. Pre-therapeutic CRP-derived markers are useful for predicting the response to dCRT and long-term outcomes.

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临床IV期食管鳞状细胞癌患者最初接受明确放化疗的结果：一项单机构观察性研究和文献综述

目的：探讨IV期食管鳞状细胞癌（ESCC）患者接受终期放化疗（dCRT）的长期预后，以及这种治疗对炎症和营养指标的影响。方法：本研究的对象是84例接受初始dCRT治疗的civ期（cT4和/或cM1，根据UICC第八分期系统）食管鳞状细胞癌（ESCC）患者。根据治疗方式调查生存结果。评估各种炎症和营养指标，如c反应蛋白（CRP）与白蛋白比率（CAR）和淋巴细胞与CRP比率（LCR）。结果：84例患者3年总生存率为45.8%。dCRT-CR组30例患者临床完全缓解（CR）。35例患者行挽救性手术，28例患者行根治性（R0）切除（手术-R0组）。手术- r0组患者的3年OS（60.7%）与dCRT-CR组（60.0%）相当。crp衍生的标志物（LCR和CAR）与dCRT的疗效显著相关（两者均为P）。结论：终末期放化疗适用于civ期ESCC患者。根治性挽救性手术为肿瘤实体的生存提供了好处。治疗前crp衍生的标记物可用于预测dCRT的反应和长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.