BACKGROUND: The role of chemotherapy in metastatic esophageal carcinoma (MEC) remains a matter of debate. The aim of this retrospective study was to analyze the survival impact of chemotherapy after stratification for prognostic factors. METHODS:Consecutive patients with MEC (1995 to 2008) were randomly assigned to a development (n = 171) and a validation cohort (n = 113). We had first identified prognostic factors using the Kaplan-Meier and Cox methods in the development cohort and then validated them in the validation cohort. Then, we analyzed the impact of chemotherapy after stratification for these prognostic factors. The majority of patients had squamous cell carcinoma (80%). RESULTS: The Cox model has retained 2 prognostic factors only: associated cancers (hazard ratio = 2.77, range 1.39-5.54, p = 0.004) and grade 3-4 dysphagia (hazard ratio = 1.44, range 1.08-2.14, p = 0.007). Median survival was 10.9 in patients with 0 (n = 77), 6.2 in those with 1 (n = 65) and 1.8 months in those with 2 prognostic factors (n = 11/171; p = 0.025). The median survival times of the patients with 0, 1 and 2 prognostic factors were 13 versus 9 months (nonsignificant, NS), 6 versus 5 months (NS) and 5 versus 1.3 months (NS) in patients with and without chemotherapy, respectively. CONCLUSION: Our data suggest that chemotherapy has no significant effect on survival for unselected MEC patients, regardless of the prognostic factors we identified.
RCT Entities:
BACKGROUND: The role of chemotherapy in metastatic esophageal carcinoma (MEC) remains a matter of debate. The aim of this retrospective study was to analyze the survival impact of chemotherapy after stratification for prognostic factors. METHODS: Consecutive patients with MEC (1995 to 2008) were randomly assigned to a development (n = 171) and a validation cohort (n = 113). We had first identified prognostic factors using the Kaplan-Meier and Cox methods in the development cohort and then validated them in the validation cohort. Then, we analyzed the impact of chemotherapy after stratification for these prognostic factors. The majority of patients had squamous cell carcinoma (80%). RESULTS: The Cox model has retained 2 prognostic factors only: associated cancers (hazard ratio = 2.77, range 1.39-5.54, p = 0.004) and grade 3-4 dysphagia (hazard ratio = 1.44, range 1.08-2.14, p = 0.007). Median survival was 10.9 in patients with 0 (n = 77), 6.2 in those with 1 (n = 65) and 1.8 months in those with 2 prognostic factors (n = 11/171; p = 0.025). The median survival times of the patients with 0, 1 and 2 prognostic factors were 13 versus 9 months (nonsignificant, NS), 6 versus 5 months (NS) and 5 versus 1.3 months (NS) in patients with and without chemotherapy, respectively. CONCLUSION: Our data suggest that chemotherapy has no significant effect on survival for unselected MEC patients, regardless of the prognostic factors we identified.
Authors: Vincent T Janmaat; Ewout W Steyerberg; Ate van der Gaast; Ron Hj Mathijssen; Marco J Bruno; Maikel P Peppelenbosch; Ernst J Kuipers; Manon Cw Spaander Journal: Cochrane Database Syst Rev Date: 2017-11-28
Authors: Sumeet K Mittal; Joe Abdo; Malika P Adrien; Binyam A Bayu; Jay R Kline; Molly M Sullivan; Devendra K Agrawal Journal: J Gastrointest Oncol Date: 2021-08
Authors: Chi Hoon Maeng; Jeeyun Lee; Paul van Hummelen; Se Hoon Park; Emanuele Palescandolo; Jiryeon Jang; Ha Young Park; So Young Kang; Laura MacConaill; Kyoung-Mee Kim; Young-Mog Shim Journal: PLoS One Date: 2012-08-03 Impact factor: 3.240
Authors: Hyun Ae Jung; Antoine Adenis; Jeeyun Lee; Se Hoon Park; Chi Hoon Maeng; Silvia Park; Hee Kyung Ahn; Young Mog Shim; Nicolas Penel; Young-Hyuck Im Journal: Cancer Res Treat Date: 2013-12-31 Impact factor: 4.679
Authors: Joe Abdo; Christopher S Wichman; Nicholas E Dietz; Pawel Ciborowski; John Fleegel; Sumeet K Mittal; Devendra K Agrawal Journal: Front Oncol Date: 2018-05-09 Impact factor: 6.244