Analysis of fistula formation of T4 esophageal cancer patients treated by chemoradiotherapy.
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
/ complications
Case-Control Studies
Chemoradiotherapy
/ adverse effects
Combined Modality Therapy
Esophageal Fistula
/ epidemiology
Esophageal Neoplasms
/ pathology
Female
Humans
Incidence
Male
Middle Aged
Neoplasm Staging
/ methods
Retrospective Studies
Risk Factors
Survival Analysis
Tomography, X-Ray Computed
/ methods
Tumor Burden
Axial size
Esophageal cancer
Fistula
Radiographic findings
T4
Journal
Esophagus : official journal of the Japan Esophageal Society
ISSN: 1612-9067
Titre abrégé: Esophagus
Pays: Japan
ID NLM: 101206627
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
13
04
2019
accepted:
05
09
2019
pubmed:
12
9
2019
medline:
16
7
2021
entrez:
12
9
2019
Statut:
ppublish
Résumé
Fistula is one of the known complications of T4 esophageal cancer (T4-EC). The standard treatment for T4-EC is chemoradiotherapy, but detailed data about fistula resulting from chemoradiotherapy in this condition are limited. In particular, radiographic findings of T4-EC with fistula have not been reported. This study assessed the risk factors of fistula based on clinical information on patients with chemoradiotherapy for T4-EC. We retrospectively reviewed the clinical data of 59 T4-EC patients who had squamous cell carcinoma without any fistula before receiving definitive or palliative chemoradiotherapy. A fistula was observed in 18 patients (31%) throughout their clinical course. The overall survival in the fistula group was significantly shorter than that in the non-fistula group (259 vs. 346 days; p = 0.0341). The axial tumor size on computed tomography (CT) was confirmed as an independent risk factor for esophageal fistula in multivariate analysis of stepwise methods [OR 1.226; 95% CI 1.109-1.411; p < 0.0001]. Twelve out of 14 patients with an axial tumor size of 50 mm or greater had developed a fistula. A large tumor size on the axial plane on CT is a risk factor for fistula formation.
Sections du résumé
BACKGROUND AND AIM
Fistula is one of the known complications of T4 esophageal cancer (T4-EC). The standard treatment for T4-EC is chemoradiotherapy, but detailed data about fistula resulting from chemoradiotherapy in this condition are limited. In particular, radiographic findings of T4-EC with fistula have not been reported. This study assessed the risk factors of fistula based on clinical information on patients with chemoradiotherapy for T4-EC.
METHODS
We retrospectively reviewed the clinical data of 59 T4-EC patients who had squamous cell carcinoma without any fistula before receiving definitive or palliative chemoradiotherapy.
RESULTS
A fistula was observed in 18 patients (31%) throughout their clinical course. The overall survival in the fistula group was significantly shorter than that in the non-fistula group (259 vs. 346 days; p = 0.0341). The axial tumor size on computed tomography (CT) was confirmed as an independent risk factor for esophageal fistula in multivariate analysis of stepwise methods [OR 1.226; 95% CI 1.109-1.411; p < 0.0001]. Twelve out of 14 patients with an axial tumor size of 50 mm or greater had developed a fistula.
CONCLUSIONS
A large tumor size on the axial plane on CT is a risk factor for fistula formation.
Identifiants
pubmed: 31506805
doi: 10.1007/s10388-019-00691-y
pii: 10.1007/s10388-019-00691-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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