title: Treatment outcome and prognostic factors in non-metastatic esophageal carcinoma.
abstract: OBJECTIVE
  To investigate the therapeutic outcome and prognostic factors in patients with non-metastatic esophageal carcinoma.
  
  
  METHODS
  Between January 1989 and December 2003, 171 patients with non-metastatic esophageal carcinoma patients were retrospectively assessed in the Department of Radiation and Oncology, Institute of Oncology, Turkey.
  
  
  RESULTS
  The distribution of the stage at presentation designated 39 stage II patients (23%) and 132 stage III patients (77%). The primary tumors were treated with surgery and postoperative radiotherapy (RT) in 29 patients (17%), with surgery, postoperative RT and chemotherapy (CT) in 17 patients (10%), with radical RT in 40 patients (23%), and with RT and CT in 47 patients (27%). Fourteen patients (8%) did not receive any postoperative adjuvant treatment. Two and three-year survival rates of the whole group were 27.0% and 14.8%, respectively. Clinical staging was the only statistically significant prognostic factor by multivariate analyses (p=0.04). Median survivals by the treatment groups were 12.5 months for surgery alone, 16 months for surgery plus postoperative RT, 15 months in surgery plus postoperative chemoradiotherapy, 9 months in radical RT alone and 17 months in chemoradiotherapy group. Survival advantage was not demonstrated for postoperative RT or RT plus CT. Outcomes were similar between the patients treated with surgery and with chemoradiotherapy (p=0.54). Patients treated with chemoradiotherapy had a longer survival than patients treated with only RT (p=0.05).
  
  
  CONCLUSIONS
  The most important prognostic factor was the stage of the disease. Survival advantage was not demonstrated for postoperative RT or RT plus CT. Outcomes were similar between patients treated by surgery and by chemoradiotherapy.
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Istanbul University, and Lutfi Kirdar Research and Training Hospital, Istanbul 34290, Turkey. kaytane@gmail.com
authors.forename: Esra K
authors.initials: EK
authors.lastname: Saglam
authors.forename: Sevil
authors.initials: S
authors.lastname: Kilciksiz
authors.forename: Naciye
authors.initials: N
authors.lastname: Ozseker
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karadeniz
authors.forename: Ethem N
authors.initials: EN
authors.lastname: Oral
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kizir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome