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Analysis of prognostic factors for esophageal squamous cell carcinoma with distant organ metastasis at initial diagnosis.
[esophageal squamous cell carcinoma]
Esophageal
cancer
is
the
eighth
most
common
malignancy
and
sixth
most
fatal
disease
worldwide
.
However
,
it
is
the
fourth
most
common
cause
of
death
in
China
.
Although
surgery
is
currently
the
recommended
course
of
treatment
,
there
are
some
patients
that
do
not
receive
radical
treatment
due
to
the
presence
of
distant
organ
or
lymph
node
metastasis
.
There
is
at
present
no
established
treatment
standard
for
esophageal
cancer
patients
with
distant
organ
metastasis
.
The
purpose
of
this
study
was
to
investigate
the
prognostic
factors
involved
in
determining
survival
of
esophageal
cancer
patients
with
distant
organ
metastasis
at
initial
diagnosis
,
and
to
provide
a
reference
for
the
planning
of
a
clinical
treatment
strategy
.
The
data
of
57
evaluable
esophageal
squamous
cell
carcinoma
patients
with
distant
organ
metastasis
at
initial
diagnosis
were
studied
retrospectively
.
The
survival
rate
was
calculated
using
the
Kaplan-
Meier
method
,
and
the
log-rank
test
was
used
to
test
the
differences
.
Multivariable
analysis
was
performed
using
the
Cox
proportion
hazards
model
.
The
median
survival
time
for
all
patients
was
6
months
(
range
,
1
-
55
months
)
,
and
the
1
-
and
2
-
year
survival
rates
were
21
.
1
%
and
11
.
8
%
,
respectively
.
The
median
survival
time
for
patients
with
single
metastasis
was
10
months
with
1
-
and
2
-
year
survival
rates
of
47
.
4
%
and
28
.
1
%
,
respectively
.
For
patients
with
multiple
metastases
,
the
survival
duration
was
5
months
,
with
1
-
and
2
-
year
survival
rates
of
7
.
9
%
and
3
.
9
%
,
respectively
(
p
Â
<
Â
0
.
001
)
.
The
1
-
and
2
-
year
survival
rates
with
multimodality
treatment
were
70
%
and
45
%
,
respectively
,
which
were
significantly
better
than
chemotherapy
alone
(
13
.
3
%
and
8
.
9
%
,
respectively
,
p
Â
=
Â
0
.
003
)
and
best
supportive
care
(
5
.
9
%
and
0
%
,
p
Â
<
Â
0
.
001
)
,
but
there
was
no
significant
difference
between
the
latter
two
groups
(
p
Â
=
Â
0
.
061
)
.
For
esophageal
squamous
cell
carcinoma
patients
with
distant
organ
metastasis
upon
initial
diagnosis
,
the
presence
of
a
single
metastasis
appeared
to
favor
overall
survival
compared
to
multiple
metastases
.
Multimodality
treatment
may
also
improve
patient
survival
,
but
chemotherapy
alone
has
not
been
established
as
a
favorable
prognostic
factor
.
Diseases
Validation
Diseases presenting
"multiple metastases"
symptom
dedifferentiated liposarcoma
esophageal squamous cell carcinoma
liposarcoma
pleomorphic liposarcoma
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