Bardol Thomas, Ferre Lorenzo, Aouinti Safa, Dupuy Marie, Assenat Eric, Fabre Jean-Michel, Picot Marie-Christine, Souche Regis
Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.
INSERM, Centre d'Investigation Clinique 1411, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.
Cancers (Basel). 2022 Aug 16;14(16):3956. doi: 10.3390/cancers14163956.
(1) Background: The management of metastatic esophageal cancer is more often limited to palliative chemotherapy. Limited data are available regarding the role of surgery that remains controversial. The aim of this systematic review is to assess the survival outcome of surgically treated metastatic esophageal cancer patients. (2) Methods: The present systematic review is designed using the PRISMA guidelines and has been registered with PROSPERO (CRD42019140306). Two reviewers independently searched and identified studies dealing with surgery for stage IV esophageal cancer in the Medline and Google Scholar databases between January 2008 and December 2019. (3) Results: Seven retrospective nonrandomized studies, totaling 1756 patients with stage IV esophageal cancer who underwent curative surgery, were included. Our analysis demonstrates a three-year overall survival rate of 23% (CI 95% 17-31) among patients undergoing surgery. Because only two comparative studies were identified, data compilation and relative risk evaluation through meta-analysis were not possible. (4) Conclusions: Multimodality treatment, including surgery in curative intent, seems associated with a significant chance of three-year overall survival. A prospective evaluation of this approach and validation of adequate selection criteria are needed.
(1) 背景：转移性食管癌的治疗通常更多地局限于姑息性化疗。关于手术的作用，现有数据有限，且仍存在争议。本系统评价的目的是评估手术治疗转移性食管癌患者的生存结局。(2) 方法：本系统评价采用PRISMA指南设计，并已在PROSPERO（CRD42019140306）注册。两名评价者独立检索并识别了2008年1月至2019年12月期间在Medline和谷歌学术数据库中涉及IV期食管癌手术的研究。(3) 结果：纳入了7项回顾性非随机研究，共1756例接受根治性手术的IV期食管癌患者。我们的分析显示，接受手术的患者三年总生存率为23%（95%CI 17-31）。由于仅识别出两项比较研究，因此无法通过荟萃分析进行数据汇总和相对风险评估。(4) 结论：多模式治疗，包括根治性手术，似乎与三年总生存率的显著机会相关。需要对这种方法进行前瞻性评估并验证适当的选择标准。
