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Abstract：
BACKGROUND: The study of oligometastatic esophageal cancer (EC) is relatively new. Preliminary data suggests that more aggressive treatment regimens in select patients may improve survival rates in oligometastatic EC. However, the consensus recommends palliative treatment. We hypothesized that oligometastatic esophageal cancer patients treated with a definitive approach (chemoradiotherapy [CRT]) would have improved overall survival (OS) compared to those treated with a purely palliative intent and historical controls.
METHODS: Patients diagnosed with synchronous oligometastatic (any histology, ≤5 metastatic foci) esophageal cancer treated in a single academic hospital were retrospectively analyzed and divided into definitive and palliative treatment groups. Definitive CRT was defined as radiation therapy to the primary site with ≥40 Gy and ≥2 cycles of chemotherapy.
RESULTS: Of 78 Stage IVB (AJCC 8th ed.) patients, 36 met the pre-specified oligometastatic definition. Of these, 19 received definitive CRT, and 17 received palliative treatment. With a median follow-up of 16.5 months (Range: 2.3-95.0 months), median OS for definitive CRT and palliative groups were 90.2 and 8.1 months (p < 0.01), translating into 5-year OS of 50.5% (95%CI: 32.0-79.8%) vs. 7.5% (95%CI: 1.7-48.9%), respectively.
CONCLUSIONS: Oligometastatic EC patients treated with definitive CRT benefited from that approach with survival rates (50.5%) that vastly exceeded historical standards of 5% at 5 years for metastatic EC. Oligometastatic EC patients treated with definitive CRT had significantly improved OS compared to those treated with palliative-only intent within our cohort. Notably, definitively treated patients were generally younger and with better performance status versus those palliatively treated. Further prospective evaluation of definitive CRT for oligometastatic EC is warranted.
METHODS: Patients diagnosed with synchronous oligometastatic (any histology, ≤5 metastatic foci) esophageal cancer treated in a single academic hospital were retrospectively analyzed and divided into definitive and palliative treatment groups. Definitive CRT was defined as radiation therapy to the primary site with ≥40 Gy and ≥2 cycles of chemotherapy.
RESULTS: Of 78 Stage IVB (AJCC 8th ed.) patients, 36 met the pre-specified oligometastatic definition. Of these, 19 received definitive CRT, and 17 received palliative treatment. With a median follow-up of 16.5 months (Range: 2.3-95.0 months), median OS for definitive CRT and palliative groups were 90.2 and 8.1 months (p < 0.01), translating into 5-year OS of 50.5% (95%CI: 32.0-79.8%) vs. 7.5% (95%CI: 1.7-48.9%), respectively.
CONCLUSIONS: Oligometastatic EC patients treated with definitive CRT benefited from that approach with survival rates (50.5%) that vastly exceeded historical standards of 5% at 5 years for metastatic EC. Oligometastatic EC patients treated with definitive CRT had significantly improved OS compared to those treated with palliative-only intent within our cohort. Notably, definitively treated patients were generally younger and with better performance status versus those palliatively treated. Further prospective evaluation of definitive CRT for oligometastatic EC is warranted.
摘要：
背景：寡转移食管癌（EC）的研究相对较新。初步数据表明，在某些患者中更积极的治疗方案可能会提高寡转移型EC的生存率。然而,共识建议姑息治疗.我们假设，与单纯姑息治疗和历史对照相比，采用确定性方法（放化疗[CRT]）治疗的寡转移食管癌患者的总体生存率（OS）有所提高。
方法：诊断为同步寡转移的患者（任何组织学，对在单一学术医院治疗的≤5个转移灶）食管癌进行回顾性分析，并分为确定性和姑息性治疗组。最终CRT被定义为在≥40Gy和≥2个周期的化疗中对原发部位进行放射治疗。
结果：78期IVB（AJCC第8版。)患者，36符合预先指定的寡转移定义。其中,19人接受了最终的CRT，17人接受姑息治疗。中位随访时间为16.5个月（范围：2.3-95.0个月），确定性CRT和姑息治疗组的中位OS分别为90.2和8.1个月(p<0.01),转换为50.5%的5年OS（95CI：32.0-79.8%）与7.5%（95CI：1.7-48.9%），分别。
结论：接受确定性CRT治疗的低转移性EC患者受益于该方法，其5年生存率（50.5%）大大超过5%的转移性EC的历史标准。在我们的队列中，与仅接受姑息治疗的患者相比，接受确定性CRT治疗的低转移性EC患者的OS显着改善。值得注意的是,与接受姑息治疗的患者相比,接受明确治疗的患者通常更年轻,表现状况更好.有必要对寡转移EC的最终CRT进行进一步的前瞻性评估。
方法：诊断为同步寡转移的患者（任何组织学，对在单一学术医院治疗的≤5个转移灶）食管癌进行回顾性分析，并分为确定性和姑息性治疗组。最终CRT被定义为在≥40Gy和≥2个周期的化疗中对原发部位进行放射治疗。
结果：78期IVB（AJCC第8版。)患者，36符合预先指定的寡转移定义。其中,19人接受了最终的CRT，17人接受姑息治疗。中位随访时间为16.5个月（范围：2.3-95.0个月），确定性CRT和姑息治疗组的中位OS分别为90.2和8.1个月(p<0.01),转换为50.5%的5年OS（95CI：32.0-79.8%）与7.5%（95CI：1.7-48.9%），分别。
结论：接受确定性CRT治疗的低转移性EC患者受益于该方法，其5年生存率（50.5%）大大超过5%的转移性EC的历史标准。在我们的队列中，与仅接受姑息治疗的患者相比，接受确定性CRT治疗的低转移性EC患者的OS显着改善。值得注意的是,与接受姑息治疗的患者相比,接受明确治疗的患者通常更年轻,表现状况更好.有必要对寡转移EC的最终CRT进行进一步的前瞻性评估。
