Survival of patients with esophageal cancer depending on the location of the primary tumor
Кіркілевський С.І., Крахмальов П.С., Кондрацький Ю.М., Фридель Р.І.
Summary. Relevance. Esophageal cancer (EC) is ranked eighth among the most common cancers in the world and sixth in male deaths from malignancies. The clinical course of the disease is caused by the rapid development of dysphagia syndrome, against which cachexia develops over several months, patients usually die from alimentary exhaustion. To date, there are almost no studies analyzing the survival of patients depending on the location of the primary tumor. Objective. Assessing the survival results of patients with EC depending on the location of the primary tumor. Materials and methods. Of the 1690 patients who had malignant esophageal tumors, the survival rate of 1465 patients with squamous cell esophageal cancer was analyzed, depending on the location of the primary tumor by TNM distribution and clinical stages. Results. Among 1690 patients with esophageal malignancies receiving treatment in the research department of tumors of the chest cavity, more than 90% were men with an average age of 58?48 years, with age fluctuations ranging from 20 to 90 years. Among the histological forms, the squamous cellular EC (86.69%) was predominant, and its frequency depended on the level of localization of the primary tumor in the esophagus — with lesions of the upper divisions and middle part of the intrathoracic department, it occurred in more than 90% of cases, and in lesions of the inferior intrathoracic and abdominal wards — at 76,05%. Among other histological forms, adenocarcinoma (82,72%) prevailed. It was the patients with squamous cell EC who were enrolled for further analysis. Depending on the level of primary tumor localization: more than half were middle-division cancer patients, and lower-division cancer patients were 1,5 times more likely than upper-division cancer patients. It is noteworthy that in the analysis of the distribution of patients by TNM and clinical stages, depending on the level of localization of the primary tumor in the esophagus, all groups were identical in almost all indicators — more than half of patients were patients with IIA clinical stage, among which 1,5 –2 times the T3N0M0 stage prevailed over the T2N0M0. Almost a third of all patients were patients with stage III, which was significantly dominated by stage T3N1M0. Almost 10% were patients with IV clinical stages, among which patients with locally common forms of the primary tumor process predominated. And the least common were IIB and especially I stage EC. Conclusion. After the analysis of the survival of patients, it can be said that the significantly better survival was in patients with squamous cell carcinoma of the lower esophagus both in the initial stages and in locally advanced processes, and the survival of patients with upper and middle divisions was not significantly different. However, no significant difference in patient survival was observed at IV clinical stages depending on the location of the primary tumor.
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