Esophageal Cancer Prognosis
There are particular factors that are used to affect the prognosis (chance of recovery) and options of treatment. The prognosis and treating options depend as follows:
- The stage of cancer (if it is affecting the part of the esophagus, comprises the whole esophageal region, or has expanded to other parts of the body).
- If complete surgical removal of the tumor is possible.
- The general health of the patient.
When the cancer of the esophagus is diagnosed in the early stages, the chances of recovery are more. The cancer of the esophagus is usually in the final stages when its diagnosis had been done. In the last stages, the cancer of the esophagus can be handled but can be cured less often. Participating in one of the clinical trials being done for improving the treatment should be reviewed.
Several factors affect the prognosis of esophageal carcinoma. A present study analysing some prognostic factors of esophageal cancer patients like age, performance status, family history, gender, past oncologic history, body mass index, and weight loss states that all these factors determine the prognosis of a patient. Moreover, some factors having an association with neoplasm including the tumor location, tumor size, stage of cancer, grade of cellular differentiation intensely affect the treatment and therefore the prognosis of esophageal cancer patients.
Factors associated with patients
Age was associated with a bad prognosis only in SCC patients. Another study also attributed the elderly to a poor survival rate 5. Previous papers demonstrated also that a family history of esophageal cancer can predict a bad prognosis 12. This finding is not in agreement with the present study.
Factors associated with neoplasm
High tumor size and high oncologic stage was associated with high mortality in SCC. This is in accordance with previous papers 5, 10. This study evinces SCC with poor cellular differentiation leads to a poor oncologic stage at the moment of diagnosis. Tachibana et al. 10 also demonstrated an association of differentiation grade and prognosis.
Factors associated with surgery
Although it could not be demonstrated the relationship between survival and the number of dissected lymph nodes, other studies showed the great importance of this variable.
The number of positive lymph nodes (more vs. less than 5 dissected nodes) is related to an increased risk of mortality (hazard ratio [HR], 1.29; 95% confidence interval [95%CI], 1.06 -1.56). according to another scientist, the test results show that patients with more than four involved lymph nodes have survival similar to that of patients with M1 disease. Consequently, the number of lymph nodes removed would be an independent factor for prognosis. a minimum of 23 regional lymph nodes should be removed.
In this study, survival improvement after curative-intent surgery must be carefully analysed, once selection for surgery (only not advanced stages) may be a bias. Esophageal carcinoma is a poor prognosis disease. In our study, after five years of follow-up, overall survival is next to 20%. Weight loss (kg), BMI variation (kg/m²), and percentage of weight loss are factors that predict a worse stage at diagnosis in squamous cell carcinoma. In adenocarcinoma, these findings were not statistically significant.