Carcinoma of the Esophagus

Andel, J.G. van; Dees, Jan; Dijkhuis, C.M.; Fokkens, W. J.; Houten, Holly Van; Jong, P. C. De; Woerkom-Eykenboom, W. M. H. van

doi:10.1097/00000658-197912000-00002

Cited by 70 publications

(5 citation statements)

References 16 publications

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“…In this study, we found that age and gender, dose and frequency of radiotherapy and the size of surface under radiotherapy are the important prognostic factors for survival. Several previous studies have also found longer survival times for women (Van Andel, 1979;Kinoshita et al, 1982;Shimada et al, 1999). Thus, the recurrence or progression of oesophagus carcinoma may relate to a hormonal factor such as testosterone or androgen.…”

Section: Discussionmentioning

confidence: 82%

Factors affecting the survival of patients with oesophageal carcinoma under radiotherapy in the north of Iran

Hajian‐Tilaki

2001

Br J Cancer

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Factors relevant to the survival of patients with oesophageal cancer under radiotherapy have been studied in northern Iran where its incidence is high. We conducted an analytical study using a historical cohort and information from the medical charts of patients with oesophageal cancer. Out of 523 patients referred to the Shahid Rajaii radiotherapy centre in Babolsar from 1992 to 1996, we followed 230 patients for whom an address was available in 1998. The frequency of prognostic factors among those not contacted was very similar to those included in the study. The data were analysed using survival analysis by the nonparametric method of Kaplan Meier and the Cox regression model to determine risk ratios (RR) of prognostic factors. Survival rates were 42% at 1 year, 21% at 2 years, and 8% at 5 years after diagnosis. Patients aged 50–64 were found to have poorer survival compared with those less than 50 (RR = 1.73, P = 0.03); the risk ratio for ages f = 65 was 1.88 (P = 0.03). Females had significantly better survival than males (RR = 0.71, P = 0.02). For each 100 rads dose of radiotherapy, the risk ratio was significantly decreased by 1% (RR = 0.99, P = 0.05); for each session of radiotherapy, the risk ratio was significantly decreased by 4% (RR = 0.96, P = 0.0001); for each square centimetre size of surface under radiotherapy, the risk ratio significantly increased (RR = 1.002, P = 0.04). We did not observe a significant difference on survival by histology, anatomical location of tumours, or type of treatment (P > 0.05). Prognosis is extremely poor. © 2001 Cancer Research Campaign http://www.bjcancer.com

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Section: Discussionmentioning

confidence: 82%

Factors affecting the survival of patients with oesophageal carcinoma under radiotherapy in the north of Iran

Hajian‐Tilaki

2001

Br J Cancer

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“…In the 81 patients from the earlier period who completed the combined treatment the actuarial corrected 5-year survival was 21 per cent, and a significantly better survival for females than for males was found (42% versus 12%) (3). The difference between the two periods is not explained by the operation mortality, which was similar in both periods.…”

Section: Reduced Sample Methods (N=8)mentioning

confidence: 76%

Therapy of Esophageal Carcinoma: Results from the Joint Group on Esophageal Carcinoma in Rotterdam

Andel

Dees

Eijkenboom

et al. 1986

Acta Radiologica: Oncology

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“…The question is whether combined treatment is better than surgery alone: an improved survival rate of 25% versus 13.5% was reported by Akakura et al over 2 consecutive time periods, whereas other simultaneous studies offeredidentical [9] or even worse [13] results. A better survival experience in Rotterdam [14] could be due to a high proportion of females (one-third) in that series. Concentrated radiation appeared to be better in the series of Kelsen et al, but in a small sample.…”

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confidence: 81%

“…Distant progression was common [3,15] and more frequent in irradiated patients, contrary to local recurrences which were less frequent [8]. Overall, long-term results of the combined treatment appeared to be better than radiation alone in a priori operable patients [4,14,16].…”

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confidence: 90%

The value of preoperative radiotherapy in esophageal cancer: Results of a study of the E.O.R.T.C.

et al. 1987

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Attempts to combine radiation therapy and surgery in patients with operable carcinoma of the esophagus began 30 years ago. The first reported surgical series showed a low rate of resectabflity and a high postoperative mortality. Results of radiation therapy alone were also disappointing in the long run, especially in patients who appeared to be excellent operative risks with small localized tumors. The rationale for a combined approach was that x-ray therapy could bring about a reduction of tumor activity and bulk, an improvement in nutritional state through the restoration of the ability to swallow, a reduction of transplantability of the tumor, and a curative effect on periesophageal regional disease which is not treated well by surgery. On the other hand, surgery often allowed an extended resection, clearing residual foci or distant esophageal wall extension. The limit of a combined approach is the toxicity of the preoperative radiation which must be mild enough to allow surgery to proceed without excessive delay or increased mortality. Numerous radiotherapy schedules were tried using different fields, doses, and fractionations, most of them in nonrandomized studies. Two prospective randomized trials have been recently reported. The final results of a third prospective trial, run by the E.O.R.T.C., will be presented. Historical StudiesComparative analysis of historical studies (Table 1) is made difficult by the frequent lack of data concerning the staging of the tumor, the delay between radiation and surgery, the toxicity and the morbidity of radiation, and the number of patients at risk for long-term evaluation.The first studies [1, 2] used long-term fractionated radiation, about 45 gray (Gy) in 4 weeks, with surgery having been performed after a 4-8-week period (or longer) of recovery. High doses (up to 50-60 Gy) were tested in Stanford, and by Akakura, but led to an unacceptable toxicity (12% lethality) [3]. The analysis of available reports (Table 1) shows that surgery had to be cancelled in as many as 50% of irradiated patients. In most series, however, the staging and the evaluation of operability were made at the end of the radiation period, not before.

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Carcinoma of the Esophagus

Cited by 70 publications

References 16 publications

Factors affecting the survival of patients with oesophageal carcinoma under radiotherapy in the north of Iran

Factors affecting the survival of patients with oesophageal carcinoma under radiotherapy in the north of Iran

Therapy of Esophageal Carcinoma: Results from the Joint Group on Esophageal Carcinoma in Rotterdam

The value of preoperative radiotherapy in esophageal cancer: Results of a study of the E.O.R.T.C.

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