Baladi Anass, Tafenzi Hassan Abdelilah, Megzar Fatim-Zahra, Cisse Ibrahima Kalil, Zouiten Othmane, Afani Leila, Essaadi Ismail, Fadli Mohammed El, Belbaraka Rhizlane
Department of Medical Oncology, Mohammed VI University Hospital of Marrakech, Marrakesh 40000, Morocco.
Biosciences and Health Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco.
Ecancermedicalscience. 2025 Apr 1;19:1882. doi: 10.3332/ecancer.2025.1882. eCollection 2025.
Esophageal squamous cell carcinoma (ESCC) is the most common subtype of esophageal cancer (EC) worldwide, with significant geographic variability in its incidence and outcomes. This study aims to analyse the characteristics of Moroccan ESCC patients, identify independent prognostic factors for mortality and assess access to surgery, chemotherapy, radiotherapy (RT) and targeted therapies.
This retrospective study analysed data from the Marrakesh-Safi regional cancer registry. Between 2014 and 2019, a total of 78 patients were histologically confirmed to have locally advanced or metastatic ESCC. Demographic, clinical and treatment data were evaluated to determine prognostic factors for overall survival (OS) using Kaplan-Meier and multivariate Cox regression analyses.
The median age was 56 years (IQR: 48-66), with a slight female predominance in stage III (59%). Dysphagia was the most frequent symptom (92%), and the thoracic esophagus was the most common tumour site (53%). Performance status was significantly worse in stage IV (31% with PS 4, < 0.001). Chemotherapy was administered to 72% of patients, with cisplatin being the most used drug. RT was more common in stage III (57% versus 33%, = 0.035), while surgery was rare (2 cases). Multivariate analysis identified performance status as a key prognostic factor (HR = 27.2, = 0.015), while RT significantly reduced mortality risk (HR = 0.07, = 0.038). Stage III patients had a median OS of 46 months, with 1- and 3-year OS rates of 84% and 78%, respectively. In contrast, stage IV patients had a median OS of 8.6 months, with 1-year and 3-year OS rates of 34% and 22%, respectively.
Patients with locally advanced or metastatic EC face poor survival outcomes. RT and performance status are key factors that significantly influence prognosis. These findings underscore the urgent need for early detection, enhanced access to multimodal treatments and improved healthcare infrastructure to improve survival outcomes.
食管鳞状细胞癌（ESCC）是全球食管癌（EC）最常见的亚型，其发病率和预后存在显著的地域差异。本研究旨在分析摩洛哥ESCC患者的特征，确定死亡率的独立预后因素，并评估手术、化疗、放疗（RT）和靶向治疗的可及性。
这项回顾性研究分析了马拉喀什-萨菲地区癌症登记处的数据。2014年至2019年间，共有78例患者经组织学确诊为局部晚期或转移性ESCC。评估人口统计学、临床和治疗数据，使用Kaplan-Meier法和多变量Cox回归分析确定总生存期（OS）的预后因素。
中位年龄为56岁（IQR：48-66），III期患者中女性略占优势（59%）。吞咽困难是最常见的症状（92%），胸段食管是最常见的肿瘤部位（53%）。IV期患者的体能状态明显较差（31%的患者PS为4，<0.001）。72%的患者接受了化疗，顺铂是最常用的药物。放疗在III期更常见（57%对33%，=0.035），而手术很少见（2例）。多变量分析确定体能状态是关键的预后因素（HR=27.2，=0.015），而放疗显著降低了死亡风险（HR=0.07，=0.038）。III期患者的中位OS为46个月，1年和3年OS率分别为84%和78%。相比之下，IV期患者的中位OS为8.6个月，1年和3年OS率分别为34%和22%。
局部晚期或转移性EC患者的生存结局较差。放疗和体能状态是显著影响预后的关键因素。这些发现强调了迫切需要早期检测、增加多模式治疗的可及性以及改善医疗基础设施以提高生存结局。
