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Purpose <p>To investigate the long-term outcomes of patients with cStage IV esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (dCRT) and the impacts of this treatment on inflammatory and nutrition markers.</p> Methods <p>The subjects of this study were 84 patients who underwent initial dCRT for cStage IV (cT4 and/or cM1 according to eighth UICC staging system) esophageal squamous cell carcinoma (ESCC). Survival outcomes were investigated according to treatment modalities. Various inflammatory and nutrition markers, such as the C-reactive protein (CRP)-to-albumin ratio (CAR) and the lymphocyte-to-CRP ratio (LCR), were evaluated.</p> Results <p>The 3-year overall survival (OS) rate of the 84 patients was 45.8%. Clinical complete response (CR) to dCRT was achieved in 30 patients (dCRT-CR group). Salvage surgery was performed for 35 patients and curative (R0) resection was achieved in 28 patients (surg-R0 group). Patients in the surg-R0 group exhibited comparable 3-year OS (60.7%) to patients in the dCRT-CR group (60.0%). CRP-derived markers (LCR and CAR) were significantly associated with the response to dCRT (both <i>P</i> &lt; 0.01) and OS (both <i>P</i> &lt; 0.01).</p> Conclusions <p>Definitive chemoradiotherapy is appropriate for patients with cStage IV ESCC. Curative salvage surgery provides survival benefits for the tumor entity. Pre-therapeutic CRP-derived markers are useful for predicting the response to dCRT and long-term outcomes.</p>

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Outcomes of patients with clinical stage IV esophageal squamous cell carcinoma treated initially with definitive chemoradiotherapy: a single-institution observational study and literature review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月4日

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  • Kotaro Sugawara,
  • Koichi Yagi,
  • Shoh Yajima,
  • Yoshiyuki Miwa,
  • Shuichiro Oya,
  • Asami Okamoto,
  • Raito Asaoka,
  • Hideomi Yamashita,
  • Yoshifumi Baba

摘要

Purpose

To investigate the long-term outcomes of patients with cStage IV esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (dCRT) and the impacts of this treatment on inflammatory and nutrition markers.

Methods

The subjects of this study were 84 patients who underwent initial dCRT for cStage IV (cT4 and/or cM1 according to eighth UICC staging system) esophageal squamous cell carcinoma (ESCC). Survival outcomes were investigated according to treatment modalities. Various inflammatory and nutrition markers, such as the C-reactive protein (CRP)-to-albumin ratio (CAR) and the lymphocyte-to-CRP ratio (LCR), were evaluated.

Results

The 3-year overall survival (OS) rate of the 84 patients was 45.8%. Clinical complete response (CR) to dCRT was achieved in 30 patients (dCRT-CR group). Salvage surgery was performed for 35 patients and curative (R0) resection was achieved in 28 patients (surg-R0 group). Patients in the surg-R0 group exhibited comparable 3-year OS (60.7%) to patients in the dCRT-CR group (60.0%). CRP-derived markers (LCR and CAR) were significantly associated with the response to dCRT (both P < 0.01) and OS (both P < 0.01).

Conclusions

Definitive chemoradiotherapy is appropriate for patients with cStage IV ESCC. Curative salvage surgery provides survival benefits for the tumor entity. Pre-therapeutic CRP-derived markers are useful for predicting the response to dCRT and long-term outcomes.