Ryu Dae-Gon, Kim Keekyoung, Liu Hongqun, Lee Samuel S, Lee Sangjune Laurence
Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 4N1, Canada.
J Clin Med. 2025 May 29;14(11):3803. doi: 10.3390/jcm14113803.
This study aimed to analyze the clinical features and prognosis of cervical esophageal squamous cell carcinoma (ESCC) compared to ESCC more inferiorly in the esophagus. Medical records of patients with ESCC between December 2008 and December 2024 were retrospectively reviewed. A total of 497 patients with ESCC were included and divided into cervical (n = 32) and non-cervical (n = 465) groups. Clinical features and survival according to treatment were compared between the two groups. Patients with cervical ESCC were older (median age 73 years vs. 67 years, = 0.047) with a higher proportion of females (18.7% vs. 10.1%, = 0.133) than patients with non-cervical ESCC. Cervical ESCC had worse differentiation (34.4% vs. 19.6%, = 0.049 in the rate of poorly differentiated carcinoma) and higher T stage (6.2% vs. 37.2%, = 0.003 in T1; 28.1% vs. 4.7%, < 0.001 in T4) than non-cervical ESCC. There was no difference in lymph node metastasis (65.6% vs. 54.6%, = 0.229) or distant metastasis (15.6% vs. 15.5%, = 0.983) between the two groups. Overall survival was lower in the cervical group (hazard ratio [HR], 1.51; 95% confidence interval [CI], 0.96-2.40; = 0.076). When comparing outcomes of patients who underwent definitive chemoradiotherapy, the complete response rate (63.6% vs. 53.4%, = 0.340) and survival (HR, 1.01; 95% CI, 0.51-1.99; = 0.973) were similar between the two groups. Although cervical ESCC had a poor prognosis due to its higher T-stage and worse differentiation compared to other locations, outcomes were similar when treated with definitive chemoradiotherapy.
本研究旨在分析颈段食管鳞状细胞癌（ESCC）与食管下段ESCC相比的临床特征和预后。回顾性分析了2008年12月至2024年12月期间ESCC患者的病历。共纳入497例ESCC患者，分为颈段组（n = 32）和非颈段组（n = 465）。比较了两组患者根据治疗情况的临床特征和生存率。颈段ESCC患者比非颈段ESCC患者年龄更大（中位年龄73岁 vs. 67岁，P = 0.047），女性比例更高（18.7% vs. 10.1%，P = 0.133）。颈段ESCC的分化程度更差（低分化癌发生率34.4% vs. 19.6%，P = 0.049），T分期更高（T1期6.2% vs. 37.2%，P = 0.003；T4期28.1% vs. 4.7%，P < 0.001）。两组在淋巴结转移（65.6% vs. 54.6%，P = 0.229）或远处转移（15.6% vs. 15.5%，P = 0.983）方面无差异。颈段组的总生存率较低（风险比[HR]，1.51；95%置信区间[CI]，0.96 - 2.40；P = 0.076）。在比较接受根治性放化疗患者的结局时，两组的完全缓解率（63.6% vs. 53.4%，P = 0.340）和生存率（HR，1.01；95% CI，0.51 - 1.99；P = 0.973）相似。尽管与其他部位相比，颈段ESCC因T分期更高和分化更差而预后不良，但接受根治性放化疗时结局相似。
