Risk Factors of Severe Benign Cicatricial Stricture After Definitive Chemoradiation for Localized T3 Esophageal Carcinoma

2020 ◽  
Vol 40 (2) ◽  
pp. 1071-1077
Author(s):  
NATSUKO SATOMI-TSUSHITA ◽  
YOSHITAKA HONMA ◽  
KENGO NAGASHIMA ◽  
YOSHINORI ITO ◽  
HIDEKAZU HIRANO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Carcinoma ◽  
Definitive Chemoradiation ◽  
Cicatricial Stricture

Risk factor analyses of severe cicatricial stricture after chemoradiotherapy for stage II/III (T3) esophageal carcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 190-190
Author(s):  
Natsuko Tsushita ◽  
Yoshitaka Honma ◽  
Kengo Nagashima ◽  
Takahiro Miyamoto ◽  
Shoko Nakamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Esophageal Carcinoma ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Oral Intake ◽  
Stage Ii ◽  
Liquid Meal ◽  
Cicatricial Stricture

190 Background: Severe benign cicatricial stricture (SBCS) is a major complication after chemoradiotherapy (CRT) for esophageal carcinoma (EC), and causes oral intake impairment leading to deterioration of quality of life even after being cured. Aim of this study was to investigate risk factors of SBCS. Methods: The subjects of this study were patients with stage II/III (T3) EC who received CRT and achieved complete response (CR) between 2000 and 2011. SBCS was determined as disability of passage by diameter-9mm endoscope. Results: Among 197 patients with Stage II/III (T3) treated by CRT, CR was obtained in 91 patients, who were included in this analysis. The median age was 63 years. Fifteen patients (16.5%) were female. The median follow-up time was 5.1 years. The cumulative incidence of SBCS was 15.0% (95%CI 9.0-24.5). Significant risk factors of SBCS were female (hazard ratio (HR) 3.3 (95%CI 1.1-10.0), p = 0.04), requirement of diced/liquid meal (HR 5.7 (95%CI 1.8-18.2), p = 0.003), tumor occupying 3/4 or grater of esophageal perimeter (HR 7.4 (95%CI 1.3-42.9), p = 0.03) and disability of endoscope passage (HR 12.7 (95%CI 4.2-38.5), p < 0.001) in univariate analysis. Hypoalbuminemia increased the risk of SBCS (HR 2.4 (95%CI 0.8-7.1), p = 0.12) marginally. As for the factors during CRT, grade 2-4 esophagitis significantly increased the risk of SBCS (HR 6.2 (95%CI 1.5-25.7), p = 0.01). Multivariate analysis showed that hypoalbuminemia (HR 3.5 (95%CI 1.1-11.1), p = 0.03) and disability of endoscope passage (HR 14.8 (95%CI 4.3-51.3), p < 0.001) were the significant risk factors of SBCS. Female (HR 1.5 (95%CI 0.5-4.9), p = 0.51) was not a significant risk factor in multivariate analysis. Conclusions: Obstructions before CRT, hypoalbuminemia and severe esophagitis during CRT are considered as risk factors of SBCS. Because SBCS occurred after completion of CRT, prophylactic treatment should be established especially for esophageal carcinoma patients with risk factors of SBCS.

Etiology and Risk Factors for Esophageal Carcinoma

2010 ◽  
Vol 28 (4-5) ◽  
pp. 641-644 ◽  
Author(s):  
Lars R. Lundell
Keyword(s):  
Risk Factors ◽  
Esophageal Carcinoma

scholarly journals Risk factors of atrial fibrillation occurring after radical surgery of esophageal carcinoma

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jun Tang ◽  
Jian-zhu Zhao ◽  
Kai-ming Ren ◽  
Fu-shuang Zheng ◽  
Xi-wen Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Esophageal Carcinoma ◽  
Radical Surgery

scholarly journals A Case Report of an Early Response to Definitive Chemoradiation for Esophageal Carcinoma Cuniculatum

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
David E. Long ◽  
Ahmad Al-Hader ◽  
Robert Emerson ◽  
Karen Rieger ◽  
William Graham Carlos ◽  
...  
Keyword(s):  
Case Report ◽  
Esophageal Carcinoma ◽  
Aggressive Behavior ◽  
Clinical Outcomes ◽  
Verrucous Carcinoma ◽  
Locally Advanced ◽  
Early Response ◽  
Definitive Chemoradiation ◽  
Definitive Therapy ◽  
Carcinoma Cuniculatum

This case report describes a 63-year-old female with a locally advanced esophageal carcinoma cuniculatum treated with definitive chemoradiation who had a rapid and early response. This case is illustrative of an aggressive behavior with rapid response and rapid recurrence. The cases of esophageal carcinoma cuniculatum as well as the closely related clinical entity of verrucous carcinoma are reviewed suggesting good clinical outcomes after definitive therapy with chemoradiation and/or surgery.

scholarly journals Risk Factor Analyses of Severe Cicatricial Stricture after Chemoradiotherapy for Stage II/III (T3) Esophageal Carcinoma

2017 ◽  
Vol 28 ◽  
pp. ix92
Author(s):  
Natsuko Kitamura (Tsushita) ◽  
Yoshitaka Honma ◽  
Kengo Nagashima ◽  
Hirokazu Shoji ◽  
Atsuo Takashima ◽  
...  
Keyword(s):  
Risk Factor ◽  
Esophageal Carcinoma ◽  
Stage Ii ◽  
Factor Analyses ◽  
Cicatricial Stricture

Predictors of Radiation Field Failure After Definitive Chemoradiation in Patients With Locally Advanced Cervical Cancer

2016 ◽  
Vol 26 (4) ◽  
pp. 737-742 ◽  
Author(s):  
Hyo Sook Bae ◽  
Yeon-Joo Kim ◽  
Myong Cheol Lim ◽  
Sang-Soo Seo ◽  
Sang-yoon Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Tumor Size ◽  
Risk Group ◽  
Locally Advanced ◽  
High Risk Group ◽  
Advanced Cervical Cancer ◽  
Locoregional Failure ◽  
Locally Advanced Cervical Cancer ◽  
Definitive Chemoradiation

PurposeWe identified the predictive factors for locoregional failure after definitive chemoradiation in patients with locally advanced cervical cancer.MethodsAltogether, 397 patients with locally advanced cervical cancer (stage IB2–IVA) were treated with definitive chemoradiation between June 2001 and February 2010. Platinum-based concurrent chemotherapy was given to all patients with median radiation dose of external beam radiotherapy 50.4 Gy in 28 fractions and intracavitary radiotherapy 30 Gy in 6 fractions. Competing risk regression analysis was used to reveal the predictive factors for locoregional failure.ResultsDuring the median follow-up of 7.2 years, locoregional failure occurred in 51 (12.9%) patients. The estimated 3-year rate of locoregional control was 89%, whereas the overall survival rate was 82%. After univariate and multivariate analyses, large tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage (III–IV) were identified as risk factors for locoregional failure (P = 0.003, P = 0.075, P = 0.005, P = 0.055, and P < 0.001, respectively). After risk grouping according to the coefficients from the multivariate model, we identified a high-risk group for locoregional failure after treatment with definitive chemoradiation as follows: (1) tumor size larger than 5 cm, and at least 1 other risk factor or (2) tumor size 5 cm or less, and at least 3 other risk factors. The cumulated estimated 3-year rate of locoregional failure of the high-risk group was 26%, which was significantly higher than that of the low-risk group (7%, P < 0.001). The 3-year overall survival rates of the 2 groups were also significantly different (57% vs 86%, P < 0.001).ConclusionsLarge tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage are all risk factors for locoregional failure after definitive platinum-based chemoradiation in patients with locally advanced cervical cancer. In the high-risk group, further clinical trials are warranted to improve the locoregional control rate.

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