Comparative analysis results of surgical treatment, chemoradiotherapy and chemotherapy with assessment of prognostic factors in cervical esophageal cancer

Aim. To analyze the results of treatment and prognostic factors of survival in patients with cervical esophageal cancer (CEC) who received surgical treatment, chemoradiation therapy and chemotherapy.

Materials and methods. The retrospective study included patients with a verified diagnosis of CEC treated at the Petrov National Medicine Research Center of Oncology from 2009 to 2018 and divided into three treatment groups: surgical treatment, chemoradiotherapy and chemotherapy. The endpoints of the study were overall survival (OS) and relapse-free survival (RFS).

Results. Ninety-seven patients were included in the study: 48 in the surgical group, 30 in the chemoradiotherapy group and 17 patients in the chemotherapeutic treatment group. The average age of patients was 59.2±10.4 years. The median OS in the surgical group was 39.1 months, in the chemoradiotherapy group – 23.9 months and 8.9 months in the chemotherapy group; the overall 3-year survival rate was 51.0% (95% CI 36.4–71.7), 44.9% (95% CI 26.9–74.9) and 26.0% (95% CI 9.9–68.2), respectively. The overall 5-year survival rate for the surgical group and the chemoradiotherapy group was 40.0% (95% CI 25.8–62.0), and 44.9% (95% CI 26.9–74.9), respectively. The presence of coronary heart disease is associated with a significant decrease in OS. The median disease-free survival in the surgical group was 19 months, in the chemoradiotherapy group – 11.5 months and 3.4 months in the chemotherapy group; the relapse-free 3-year survival rates were 44.1% (95% CI 30.2–64.4), 25.0% (95% CI 11.7–53.4) and 14.3% (95% CI 4.0–51.5), respectively. The relapse-free 5-year survival rate for the surgical treatment group and the chemoradiotherapy group was 34.6% (95% CI 21.6–55.3), and 25.0% (95% CI 11.7–53.4). The presence of peptic ulcer disease was statistically significantly associated with higher overall and RFS regardless of the treatment received.

Conclusion. In our study, surgical treatment of the CEC showed better overall and RFS rates compared with chemoradiotherapy. The presence of coronary heart disease and peptic ulcer disease are prognostic factors for overall and RFS.