PS02.233: PRETREATMENT PROGNOSTIC FACTORS IN PATIENTS WITH RESECTABLE CSTAGE II-IV THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract Background Background Advanced esophageal cancer patients often develop tumor recurrence even after curative resection. Inexpensive and easily available prognostic factors are expected in daily clinical practice. The aim of this study was to identify the prognostic factors in patients with resectable cStage II-IV thoracic esophageal squamous cell carcinoma. Methods Patients and Methods The study included 118 patients who underwent esophagectomy with curative intent for resectable cStage II-IV thoracic ESCC between January 2000 and December 2014. Time-dependent receiver operating characteristic curve analyses for 3-year overall survival (OS) as the endpoint were calculated, and the maximal Youden index was estimated to set the cut-off value for continuous variables. Survival rates were calculated by Kaplan-Meier method, and survival curves were compared using log-rank test. Univariate analysis and multivariate analysis for OS were conducted with Cox proportional hazards models. Results Results The median follow-up period was 33 months (1–160 months). The 5-year OS rate for the entire study population was 52.2%. In univariate analysis, age (70 < ), sex, performance statue, American Society of Anesthesiologists Physical Status (ASA), serum squamous cell carcinoma antigen level (1.2 ng/ml < ), lymphocyte count (≤ 1172/μl), serum albumin level (≤ 3.7 g/dl), total cholesterol level (≤ 193 mg/dl), and C-reactive protein level (0.28 < mg/dl) were significantly associated with OS. In multivariate analysis, ASA (HR for ASA 2: 1.457, 95%CI 0.594–3.579; HR for ASA 3: 7.427, 95%CI 2.189–25.199; P = 0.001) and total cholesterol level (HR 0.506, 95% CI 0.261–0.983; P = 0.044) were independent prognostic factors for OS. The 5-year relapse free survival (RFS), cancer specific survival (CSS) and OS were 58.4%, 74.5% and 67.5% in high- total cholesterol group, and 38.7%, 51.3% and 39.1% in low- total cholesterol group, respectively (P = 0.031 in RFS, P = 0.004 in CSS, and P = 0.002 in OS). Conclusion Our findings showed that pretreatment total cholesterol level and ASA are independent prognostic factors of overall survival in patients with resectable cStage II-IV thoracic esophageal squamous cell carcinoma. Disclosure All authors have declared no conflicts of interest.

Download Full-text

Clinical Efficacy and Safety of Apatinib for Maintenance Treatment in Patients with Advanced Esophageal Squamous Cell Carcinoma

10.21203/rs.3.rs-23991/v1 ◽

2020 ◽

Author(s):

Guohui Liu ◽

Chunbo Wang ◽

Mingyan E

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Clinical Efficacy ◽

Squamous Cell ◽

Maintenance Treatment ◽

Adverse Reactions ◽

Remission Rate ◽

Univariate Analysis

Abstract Background: To investigate the clinical efficacy,safety and prognostic factors of the therapy that apatinib is used for maintenance treatment in patients with advanced esophageal squamous cell carcinoma. Methods: We select 46 patients with advanced esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy in our hospital from January 2017 to February 2019, all of them were treatment with apatinib. Analysis the clinical efficacy, adverse reactions and prognostic factors. Meanwhile, the expression of patients’VEGFR-2、NF-kB was detected by immunohistochemical SABC method,and the microvessel density and microlymphatic tube density were counted.Analysis of the relationship between indicators and MVD, MLVD counts and the efficacy of apatinib.Results: We found that oral treatment of apatinib in VEGFR-2、NF-kB positive group was better than that in negative group. The partial remission rate of patients was 26.09%; the disease control rate was 67.39%.The main adverse reactions were hypertension (60.87%); hand and foot syndrome (34.77%); proteinuria (36.96%). The degree of adverse reactions was mainly grade 1~2. The median progression-free survival was 3.7 months and the median overall survival was 7.2 months. Log-Rank univariate analysis showed that the degree of adverse reactions and ECOG score were related to OS in patients with advanced esophageal squamous cell carcinoma.Cox multivariate regression analysis showed that the degree of adverse reactions and ECOG score were independent factors affecting OS in patients with advanced esophageal squamous cell carcinoma.Conclusion: Positive expression of VEGFR-2 and NF-kB can be used as a biological reference target for targeted treatment of oral apatinib. Apatinib has a certain clinical effect in the maintenance treatment of advanced esophageal squamous cell carcinoma patients after treatment, with mild adverse reactions and high safety.

Download Full-text

Experience of cetuximab in the salvage treatment for recurrent/metastatic oral squamous cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e16006 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e16006-e16006

Author(s):

Jin-Ching Lin ◽

Shih-An Liu ◽

Chen-Chi Wang ◽

Ching-Ping Wang

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Response Rate ◽

Karnofsky Performance Status ◽

Univariate Analysis ◽

Disease Extent

e16006 Background: We investigated the efficacy, toxicity, and prognostic factors of salvage chemotherapy plus cetuximab in patients with recurrent/metastatic oral squamous cell carcinoma (OSCC). Methods: A total of 30 patients with recurrent/metastatic OSCC were treated by an outpatient weekly multi-drug combination chemotherapy plus cetuximab 400 mg/m2 loading in day 1, then 250 mg/m2 every week. The major chemotherapy regimen consisted of MEMOCLUB (methotrexate 30 mg/m2 d1, epirubicin 30 mg/m2 d1, alternating with mitomycin-C 4 mg/m2 d8, oncovin 1 mg/m2 d8, cisplatin 25 mg/m2 d8, leucovorin 120 mg/m2 d8, 5-fluorouracil 1000 mg/m2 d8, and bleomycin 10 mg/m2 d8) or GV (gemcitabine 1000mg/m2 d1, and vinorelbine 25 mg/m2 d8). Results: Baseline characteristics are as followings: median age=45 (range 32-73); male/female=28/2; Karnofsky performance status 80%/70%/60%/50%=7/18/3/2. Most patients had heavily treated history — first recurrence in 11 cases, second recurrence in 6, and third or more recurrence in 13. The disease extent consists of 25 (83.3%) locoregional recurrences, 3 (10.0%) distant metastasis, and 2 (6.7%) locoregional + metastatic diseases. Grade 3/4 toxicity included leucopenia (46.7%), anemia (33.3%), thrombocytopenia (6.7%), mucositis (6.7%) and skin rashes (20.0%). We obtained a high overall response rate of 66.7% (7 CR, 13 PR, 6 SD, 3 PD, and 1 unevaluable). So far, there are 22 deaths and 8 alive. The overall survival time ranges from 48-1365 days with a median of 312 days. One-year overall survival rate is 49%. Two favorable prognostic factors were found by univariate analysis- disease extent (locoregional vs. distant disease, HR=0.1509, 95%CI=0.0008-0.0592) and tumor response (CR+PR vs. SD+PD, HR=0.2255, 95%CI=0.0277-0.2984). Conclusions: Cetuximab plus weekly outpatient multi-drug chemotherapy has a high response rate and encouraging survival with acceptable toxicity in recurrent/metastatic OSCC patients.

Download Full-text

Squamous cell carcinoma of the oral tongue: a 25-year, single institution experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215108003186 ◽

2008 ◽

Vol 123 (1) ◽

pp. 114-120 ◽

Cited By ~ 5

Author(s):

M S Mosleh-Shirazi ◽

M Mohammadianpanah ◽

M A Mosleh-Shirazi

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Cell Carcinoma ◽

Squamous Cell ◽

Univariate Analysis ◽

Disease Stage ◽

Treatment Schedule ◽

Oral Tongue ◽

Single Institution

AbstractAim:To report the characteristics, prognostic factors and treatment outcomes of 102 patients with squamous cell carcinoma of the oral tongue treated and followed up at a single institution over a 25-year period.Patients and methods:This retrospective study was carried out by auditing the medical records of 102 patients diagnosed with squamous cell carcinoma of the oral tongue and treated at our institution between 1982 and 2007. Patient follow up ranged from nine to 310 months (median 35 months). Fifty per cent of the patients were treated with surgery followed by a combination of chemotherapy and radiotherapy (43.1 per cent received concurrent chemoradiation and 6.9 per cent received sequential chemotherapy and radiotherapy), whereas 29.4 per cent received surgery followed by adjuvant radiotherapy alone. The remaining patients (20.6 per cent) did not undergo surgery and were treated with definitive radiotherapy with or without chemotherapy.Results:There were 48 men and 54 women. The age at presentation was 19–85 years (median 57 years). The peak incidence was observed between 60 and 70 years. Resection margins were clear in 75 per cent of patients and involved in 25 per cent. Stage I disease was found in 11.8 per cent of patients, stage II in 34.3 per cent, stage III in 22.5 per cent and stage IV in 31.4 per cent. The five-year disease-free survival and overall survival were 65.7 and 72.5 per cent, respectively. Thirty-five patients suffered recurrence after treatment, 74.0 per cent of them at the site of initial cervical nodal involvement. Univariate analysis for overall survival revealed the following as prognostic factors: treatment schedule (surgical vs non-surgical; p < 0.001); age (<60 years vs ≥60 years; p = 0.038); extent of cervical lymph node involvement (p = 0.015); primary tumour stage (p < 0.001); node stage (p = 0.034); and disease stage (p = 0.013). However, on multivariate analysis, only non-surgical treatment (p = 0.001) and advanced disease stage (p = 0.05) were found to have a negative influence on survival.Conclusions:Our limited data suggest that, in Iran, squamous cell carcinoma of the oral tongue tends to present at a locally advanced stage, with a high frequency of locoregional failure and a poor outcome. Combined modality therapy should be considered for the majority of patients with squamous cell carcinoma of the tongue.

Download Full-text

PS02.214: ANALYSIS OF PROGNOSTIC FACTORS IN RECURRENCE CASES AFTER SURGERY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.214 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 182-183

Author(s):

Mitsuo Nishiyama ◽

Shigeru Takeda ◽

Shinsuke Kanekiyo ◽

Masahiro Kitahara ◽

Michihisa Iida ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Univariate Analysis ◽

Locoregional Therapy ◽

Postoperative Pneumonia ◽

Multiple Site ◽

Significant Difference

Abstract Background Esophageal cancer is one of the most malignant gastrointestinal cancers and prognosis in recurrent cases remains extremely poor. However some studies show a relatively favorable prognosis among patients with solitary recurrence site who undergo locoregional therapy. It is important to clarify prognostic factors in postrecurrence cases. Methods This study included 156 patients who underwent curative resection for esophageal squamous cell carcinoma from January 2005 to December 2014. In this retrospective study we analysed relationship between clinicopathologic factors and prognosis after recurrence among these 156 patients. Results The average age was 65.2 years (± 8.2), 34 males, 11 females, The frequency of recurrence is pStage I: 2/36 cases (5.6%), pStage II: 7/48 cases (15%), pStage III: 21/43 cases (49%), pStage IVa: 8/11 cases (73%). Median survival time after recurrence was 377 (29 - 3266 days), and a 1 year/2 years/3 year survival rate after relapse was 50%/24%/11%. Patients with recurrent disease were offered treatment with chemotherapy + surgery (5 cases, 11%), chemotherapy + radiation (17 cases, 38%), chemotherapy (18 cases, 40%) and BSC (5 cases, 11%). MST was not reached in the chemotherapy + surgery group (741- 3266 days), 431 days (91–2324 days) in the chemotherapy + radiation group, 223 days (85–1079 days) in the chemotherapy group, and 52 days in the BSC group. There was a significant difference between each groups (P < 0.03). In univariate analysis, age (≤ 65/ > 65) single/multiple site recurrence, presence or absence of postoperative pneumonia, presence or absence of ARDS was selected as a prognostic factor after recurrence. In multivariate analysis, single/multiple site recurrence(HR 10.2, 95%CI 2.619–39.8, P = 0.0008), Postoperative pneumonia (HR 3.6, 95% CI 1.186 - 10.867, P = 0.024), postoperative ARDS (HR 5.6, 95% CI 1.209 - 26, 3, P = 0.0276) was selected. Conclusion Postoperative pulmonary complications might be related and aggressive local control for single site recurrence might improve the prognosis after recurrence of thoracic esophageal squamous cell carcinoma. Disclosure All authors have declared no conflicts of interest.

Download Full-text

Nomogram based on SIS predicting the survival of non-surgical thoracic esophageal squamous cell carcinoma treated by IMRT

10.21203/rs.3.rs-404753/v1 ◽

2021 ◽

Author(s):

Xingyu Du ◽

Shuchai Zhu ◽

Jing Dong ◽

Ke Yan ◽

Xiaobin Wang ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Inflammatory Markers ◽

Progression Free Survival ◽

Data Set ◽

Free Survival

Abstract Background: Several inflammatory markers have been reported to be associated with clinical outcomes in patients with esophageal squamous cell carcinoma (ESCC). This study was to evaluate several pre-radiotherapy serum inflammatory indicators, including the neutrophil / lymphocytes ratio (NLR), platelet / lymphocyte (PLR), systemic immune-inflammatory index (SII), systemic inflammation score(SIS), and compare which one has the highest predicted survival value. Finally, combining inflammatory markers with traditional prognostic factors, a new Nomogram model was developed to predict overall survival (OS) and progression-free survival (PFS) for ESCC patients receiving radiotherapy (RT) or chemoradiotherapy (CRT). Methods: This study retrospectively reviewed the data of 245 patients with thoracic esophageal squamous cell carcinoma (ESCC) underwent RT or CRT in the Fourth Hospital of Hebei Medical University from January 2013 to December 2015. The survival differences of these indexes were compared by the Kaplan-Meier method, and the univariate and the multivariate analyses were performed to determine these prognostic factors of overall survival (OS) and progression-free survival (PFS). Multivariate Cox proportional hazards regression models were used to create nomogram for OS and PFS.Results: 239 patients met the eligibility criteria. The estimated 1-, 3-, and 5-year OS and PFS rates were 74.6%, 36.8%, 26.5% and 58.4%, 31.3%, 20.5%, respectively, for the whole group. The difference in survival between OS and PFS was significant when univariate analysis were applied based on these inflammation-based measures. Multivariate analysis showed that tumor length, T stage, TNM stage, chemotherapy, SIS were predictive variables for OS and PFS in the multivariate model. The nomogram model established based on multivariate models of training data set had good predictive ability, the unadjusted C-index was 0.701 (95% CI, 0.662– 0.740) and 0.695 (95% CI, 0.656 - 0.734) for OS and PFS. Conclusions: This study show that SIS, as a comprehensive indicator of inflammation and nutrition, had the strongest predictive power for evaluating prognosis. Moreover, our nomogram can accurately predict OS and PFS after treatment and may provide guidance regarding adjuvant therapy and surveillance.

Download Full-text