Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Department of Oncology, Johns Hopkins Medicine, Baltimore, MD, USA.
J Gastrointest Surg. 2019 Sep;23(9):1721-1728. doi: 10.1007/s11605-019-04160-w. Epub 2019 Feb 26.
Metastatic carcinoma to skeletal muscle and/or subcutaneous fat is a rare event. Only 27 cases of esophageal cancer to soft tissue have been described in the English-language literature.
Our goal was to describe the prevalence and clinical characteristics of soft-tissue metastasis among patients with primary esophageal cancer at a single institution.
We performed a retrospective review of all patients with primary esophageal cancer. Data points analyzed included histologic subtype, anatomic location, metastasis pattern, treatment, and survival. Kaplan-Meier curves were used to estimate survival time, and log-rank tests were used for comparisons. For all analyses, P < 0.05 was considered significant.
Of 1341 patients with primary esophageal cancer, 25 (1.9%) had metastases to soft tissue. Soft-tissue metastases were diagnosed at a median age of 64 years, a median 9.6 months after esophageal cancer diagnosis. Adenocarcinoma was the predominant histopathological type, and soft-tissue metastasis was most common in the lower extremity. Local intervention was used for 10 symptomatic patients with favorable prognoses. Chemotherapy was the only treatment modality in 18 patients. Median survival time after diagnosis of soft-tissue metastasis was 8.9 months and was longer in patients with metastasis in soft tissue only (24.6 months, P = 0.007) and in those who received local intervention (11.1 months vs those who did not, P = 0.020).
We estimate the prevalence of soft-tissue metastasis to be 1.9% among patients with esophageal cancer. Local intervention may be beneficial for patients in otherwise good health with symptomatic soft-tissue lesions.
转移性癌累及骨骼肌和/或皮下脂肪是一种罕见的事件。在英文文献中,仅有 27 例食管癌累及软组织。
我们的目标是描述单一机构中原发性食管癌患者软组织转移的发生率和临床特征。
我们对所有原发性食管癌患者进行了回顾性研究。分析的数据点包括组织学亚型、解剖部位、转移模式、治疗和生存。采用 Kaplan-Meier 曲线估计生存时间,并采用对数秩检验进行比较。所有分析中,P<0.05 被认为具有统计学意义。
在 1341 例原发性食管癌患者中,有 25 例(1.9%)发生软组织转移。软组织转移的诊断年龄中位数为 64 岁,距食管癌诊断中位数时间为 9.6 个月。腺癌是主要的组织病理学类型,软组织转移最常见于下肢。10 例有症状的患者采用局部干预,预后良好。18 例患者仅接受化疗。诊断为软组织转移后,中位生存时间为 8.9 个月,仅发生软组织转移患者的生存时间更长(24.6 个月,P=0.007),且接受局部干预的患者生存时间更长(11.1 个月 vs 未接受局部干预的患者,P=0.020)。
我们估计食管癌患者软组织转移的发生率为 1.9%。对于有症状且身体状况良好的患者,局部干预可能有益。