Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7708-7719
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7708
Short- (30-90 days) and mid-term (1-3 years) outcomes and prognostic factors of patients with esophageal cancer undergoing surgical treatments
Meng-Kun Shi, Yun-Qing Mei, Jia-Lun Shi
Meng-Kun Shi, Yun-Qing Mei, Department of Cardiothoracic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China
Jia-Lun Shi, Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Author contributions: Shi MK contributed to conceptualization, methodology, data curation and analysis, writing (original draft), and visualization; Mei YQ contributed to writing (review and editing) and supervision; Shi JL contributed to writing (review and editing), acquisition of data, and supervision; all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Heping Hospital Affiliated to Changzhi Medical College (approval number: 2020 (037), approval date: July 22, 2020).
Informed consent statement: The requirement for informed consent was waived by the committee due to the retrospective study design.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-Lun Shi, MS, Doctor, Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China. hepingdoctor@126.com
Received: September 15, 2021
Peer-review started: September 15, 2021
First decision: October 18, 2021
Revised: November 30, 2021
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: August 6, 2022
Processing time: 309 Days and 20.5 Hours
Abstract
BACKGROUND

The factors influencing the prognosis of patients with esophageal cancer vary among studies and are still poorly known.

AIM

To determine the factors associated with survival in patients with esophageal cancer.

METHODS

This retrospective study included patients with esophageal cancer admitted between January 2017 and March 2020 at Heping Hospital Affiliated to Changzhi Medical College. All patients were treated according to the available guidelines. Follow-up was censored in October 2020. Univariable and multivariable Cox regression analyses were used to determine the independent risk factors for overall survival (OS).

RESULTS

In total, 307 patients were included. Their median age was 64 (range, 44-79) years, 63.5% were male, and the median disease course was 2 (0.1-36) months. The median tumor size was 3 (0-10) cm. Most patients were T3 (29.6%), N0 (70.0%). Most tumors were grade 2 (48.2%), and 87.3% were squamous cell carcinoma. The in-hospital mortality was 16.9%, the 30-day mortality was 19.9%, and the 90-day mortality was 25.4%. The cumulative OS rates at the last follow-up were 82.1% (95%CI: 67.7%-96.5%) for stage 0/I/II and 47.4% (95%CI: 16.5-78.6%) for stage III/IVA (P < 0.001). The multivariable analysis showed that creatinine levels (HR = 1.02, 95%CI: 1.00-1.03, P = 0.050), pTNM III/IVA (HR = 4.19, 95%CI: 2.19-8.01, P < 0.001), adjuvant radiotherapy and/or chemotherapy (HR = 0.23, 95%CI: 0.11-0.49), and the Comprehensive Complication Index (CCI) (HR = 1.02, 95%CI: 1.004-1.03, P = 0.011) were independently associated with OS.

CONCLUSION

The survival of patients with esophageal cancer is poor, especially those with pTNM III/IVA. pTNM stage III/IVA, CCI, and adjuvant therapy (radiotherapy and/or chemotherapy) are independently associated with OS.

Keywords: Esophageal cancer; Survival; Prognosis; Factors; Multivariable analysis

Core Tip: The factors influencing prognosis in esophageal cancer vary among studies and are still poorly known. Therefore, this study aimed to determine the factors related to the survival of patients with esophageal cancer. The results showed that the in-hospital mortality was 16.9%, the 30-day mortality was 19.9%, and the 90-day mortality was 25.4%. Hence, the survival of patients with esophageal cancer is poor, especially those with pTNM III/IVA disease. pTNM stage III/IVA, Comprehensive Complication Index, and adjuvant therapy (radiotherapy and/or chemotherapy) are independently associated with overall survival. These results help delineate the factors associated with poor survival in patients with esophageal cancer.