AI Article Synopsis
- Conversion therapy, involving surgery or chemoradiotherapy, is being explored for treating esophageal squamous cell carcinoma (ESCC) patients with distant metastases, which were previously considered incurable.
- A study reviewed 147 patients who underwent conversion therapy, revealing that most had major complications post-surgery, but overall survival rates were promising, with a 5-year survival rate of 31.7% for patients who responded to treatment.
- The research concluded that conversion therapy for ESCC with distant metastasis is not only safe but also may lead to better patient outcomes, particularly for those who show a positive response to treatment.
Article Abstract
Background: Patients with esophageal squamous cell carcinoma (ESCC) with distant metastasis were treated with systemic chemotherapy. Recent advances in multimodal treatments have made conversion therapy a viable option for patients with incurable ESCC.
Objective: We aimed to assess the safety and efficacy of conversion therapy for ESCC with distant metastases.
Methods: Conversion therapy was defined as surgery or chemoradiotherapy (CRT) used to cure tumors that were previously considered incurable because of distant metastasis. We conducted a retrospective review of patients who underwent ESCC conversion therapy and assessed the treatment outcomes, including adverse events and survival rates.
Results: A total of 147 patients from 22 institutions were included. Systemic chemotherapy was initially administered to all patients. The most common M1 factor was the para-aortic lymph node, accounting for 55% of cases. Following the initial treatment, 116 patients underwent surgery, with 31 receiving CRT as conversion therapy. Postoperative complications in surgery patients included pneumonia (16%), anastomotic leakage (7%), and recurrent laryngeal nerve palsy (6%). During CRT, 18% of patients developed grade 3 or higher non-hematological toxicities. The 5-year overall survival (OS) rate was 31.7%. Pathological responders had significantly longer OS than non-responders (hazard ratio 0.493, p = 0.012). The distribution of distant metastasis, regimen type, clinical response, and conversion therapy modality did not have a significant impact on OS.
Conclusions: Conversion therapy can be safely performed for ESCC with distant metastasis and has a favorable prognosis.
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| http://dx.doi.org/10.1245/s10434-024-16196-7 | DOI Listing |
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