Shi MK, Mei YQ, Shi JL. Short- (30-90 days) and mid-term (1-3 years) outcomes and prognostic factors of patients with esophageal cancer undergoing surgical treatments. World J Clin Cases 2022; 10(22): 7708-7719 [PMID: 36158480 DOI: 10.12998/wjcc.v10.i22.7708]
Corresponding Author of This Article
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
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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
ARTICLE HIGHLIGHTS
Research background
Esophageal cancer is the ninth cancer worldwide in terms of incidence but the sixth in mortality. The prognosis of esophageal cancer is poor.
Research motivation
The factors influencing the prognosis of patients with esophageal cancer vary among studies and are still poorly known. Some predictive models are available, but their value is limited.
Research objectives
This study aimed to determine the factors related to the survival of patients with esophageal cancer.
Research 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).
Research results
Among 307 patients, the in-hospital mortality was 16.9%, the 30-day mortality was 19.9%, and the 90-day mortality was 25.4%. The patients showed a cumulative OS rate at the last follow-up of 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). 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.
Research conclusions
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. These results could help manage patients by identifying those needing closer follow-up.
Research perspectives
These results could help delineate the factors associated with poor survival in patients with esophageal cancer. Identification of the factors that could help refine prognostication is important since two patients with the same histological grade and TNM staging can have different survival. These results should be validated in large cohorts of patients from multiple centers.
