The Outcomes of Multi-Disciplinary Treatment of
Esophageal Cancer in Vajira Hospital
Chanyoot Bandidwattanawong MD¹, Orawan Jedsadatud MD²
Affiliation :
¹ Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand ² Department of Internal Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background : Esophageal cancer is one of the most fatal and difficult-to-treat cancer. Multi-modality management is the key to success of improving
outcomes, however, which modality is the most proper is difficult to determine.
Objective : To evaluate the overall survival (OS) of patients with early or locally-advanced (E/LA) esophageal carcinoma treated in Vajira Hospital. The outcomes of the multi-modality management among patients with E/LA diseases were evaluated.
Materials and Methods : The retrospective analyses of esophageal carcinoma patients who attended at Vajira Hospital between January 1, 2012 and December 31, 2016 were performed.
Results : There were 86 patients with complete medical records. The median age was 60.5 years (IQR 52 to 66). Sixty-five patients (75.6%) presented with E/LA diseases. Most of the patients had primary site at thoracic part of esophagus (58 patients, 67.4%) and had squamous cell carcinoma histology (84 patients, 97.7%). Tri-modality treatment including neoadjuvant chemoradiation and esophagectomy for clinically fitted patients without evidence of mediastinal involvement and non-regional lymph node metastasis resulted in the best survival outcome [28.56 months (IQR 10.64 to 46.47)]. The OS of patients with E/LA disease was only 9.15 months (IQR 4.49 to 23.02). Male patients, non-cervical site, and non-surgical treatment were associated with the worse OS.
Conclusion : The outcomes of patients with esophageal carcinoma treated in a real-world practice is still not impressive. Tri-modality management would be the best paradigm; however, it is suitable for well-selected patients.
Received 26 May 2020 | Revised 21 August 2020 | Accepted 21 August 2020
doi.org/10.35755/jmedassocthai.2021.01.11486
Keywords :
Esophageal cancer, Multi-modality treatment, Real-world practice
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