Tomoko Katsui Taniyama1, Takashi Tsuda2, Kunihisa Miyakawa3, Hiroyuki Arai4, Ayako Doi4, Mami Hirakawa4, Yoshiki Horie4, Takuro Mizukami4, Naoki Izawa4, Takashi Ogura4, Yu Sunakawa4, Takako Eguchi Nakajima4. 1. Department of Medical Oncology, Tokyo Saiseikai Mukojima Hospital, Tokyo, Japan. 2. Department of Clinical Oncology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. tatsuda@marianna-u.ac.jp. 3. Department of Radiology, St. Marianna University School of Medicine, Kanagawa, Japan. 4. Department of Clinical Oncology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
Abstract
BACKGROUND AND AIM: Fistula is one of the known complications of T4 esophageal cancer (T4-EC). The standard treatment for T4-EC is chemoradiotherapy, but detailed data about fistula resulting from chemoradiotherapy in this condition are limited. In particular, radiographic findings of T4-EC with fistula have not been reported. This study assessed the risk factors of fistula based on clinical information on patients with chemoradiotherapy for T4-EC. METHODS: We retrospectively reviewed the clinical data of 59 T4-EC patients who had squamous cell carcinoma without any fistula before receiving definitive or palliative chemoradiotherapy. RESULTS: A fistula was observed in 18 patients (31%) throughout their clinical course. The overall survival in the fistula group was significantly shorter than that in the non-fistula group (259 vs. 346 days; p = 0.0341). The axial tumor size on computed tomography (CT) was confirmed as an independent risk factor for esophageal fistula in multivariate analysis of stepwise methods [OR 1.226; 95% CI 1.109-1.411; p < 0.0001]. Twelve out of 14 patients with an axial tumor size of 50 mm or greater had developed a fistula. CONCLUSIONS: A large tumor size on the axial plane on CT is a risk factor for fistula formation.
BACKGROUND AND AIM: Fistula is one of the known complications of T4 esophageal cancer (T4-EC). The standard treatment for T4-EC is chemoradiotherapy, but detailed data about fistula resulting from chemoradiotherapy in this condition are limited. In particular, radiographic findings of T4-EC with fistula have not been reported. This study assessed the risk factors of fistula based on clinical information on patients with chemoradiotherapy for T4-EC. METHODS: We retrospectively reviewed the clinical data of 59 T4-ECpatients who had squamous cell carcinoma without any fistula before receiving definitive or palliative chemoradiotherapy. RESULTS: A fistula was observed in 18 patients (31%) throughout their clinical course. The overall survival in the fistula group was significantly shorter than that in the non-fistula group (259 vs. 346 days; p = 0.0341). The axial tumor size on computed tomography (CT) was confirmed as an independent risk factor for esophageal fistula in multivariate analysis of stepwise methods [OR 1.226; 95% CI 1.109-1.411; p < 0.0001]. Twelve out of 14 patients with an axial tumor size of 50 mm or greater had developed a fistula. CONCLUSIONS: A large tumor size on the axial plane on CT is a risk factor for fistula formation.
Authors: A Ohtsu; N Boku; K Muro; K Chin; M Muto; S Yoshida; M Satake; S Ishikura; T Ogino; Y Miyata; S Seki; K Kaneko; A Nakamura Journal: J Clin Oncol Date: 1999-09 Impact factor: 44.544
Authors: A Chak; M Canto; H Gerdes; C J Lightdale; R H Hawes; M J Wiersema; G Kallimanis; T L Tio; T W Rice; H W Boyce Journal: Gastrointest Endosc Date: 1995-12 Impact factor: 9.427
Authors: Bruce D Minsky; Thomas F Pajak; Robert J Ginsberg; Thomas M Pisansky; James Martenson; Ritsuko Komaki; Gordon Okawara; Seth A Rosenthal; David P Kelsen Journal: J Clin Oncol Date: 2002-03-01 Impact factor: 44.544