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寡转移型食管胃交界部癌患者的肿瘤学结局。

Oncological outcomes of patients with oligometastatic oesophagogastric cancer.

机构信息

Oxford University Hospital NHS Foundation Trust, UK.

Oxford University Hospital NHS Foundation Trust, UK.

出版信息

Eur J Surg Oncol. 2024 Apr;50(4):108231. doi: 10.1016/j.ejso.2024.108231. Epub 2024 Mar 5.

Abstract

Oligometastatic oesophagogastric cancer was recently defined by consensus as the presence of no more than two metastases and an 18-week period of oncological stability during chemotherapy. The number of patients who fit this criterion and whether their oncological outcome differs from those with multi-metastatic disease is unknown. We analysed a database of 497 patients from 2017 to 2021 with metastatic oesophageal cancer. In total, 36 (7.2%) had oligometastatic disease and significantly improved median overall survival (mOS) versus multi-metastatic disease. In synchronous OMD, mOS was 26.8 months versus 7.3 months and in metachronous OMD, 38.6 months versus 6.1 months (both p < 0.0001). A subset of oligometastatic patients who underwent surgical management of their oligometastases after primary tumour resection demonstrated significantly increased mOS compared with systemic treatment alone (60 months versus 24.4 months; p < 0.038). Oligometastatic oesophagogastric cancer is associated with improved oncological outcome when compared to multi-metastatic disease. Further work is needed to identify patients who will benefit from aggressive treatment of metastatic oesophagogastric cancer.

摘要

寡转移型食管胃交界部癌最近被定义为存在不超过两个转移灶和化疗期间长达 18 周的肿瘤稳定性。符合这一标准的患者数量及其肿瘤学结局是否与多转移疾病不同尚不清楚。我们分析了 2017 年至 2021 年期间 497 例转移性食管癌患者的数据库。共有 36 例(7.2%)为寡转移型疾病,与多转移型疾病相比,中位总生存期(mOS)显著改善。在同步 OMD 中,mOS 为 26.8 个月,而在异时性 OMD 中为 38.6 个月(均 p<0.0001)。在原发性肿瘤切除后对寡转移灶进行手术治疗的寡转移型患者亚组,mOS 明显高于单纯全身治疗(60 个月 vs 24.4 个月;p<0.038)。与多转移疾病相比,寡转移型食管胃交界部癌的肿瘤学结局得到改善。需要进一步研究以确定哪些患者将从转移性食管胃交界部癌的积极治疗中获益。

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