title: Management of esophageal carcinoma associated with cirrhosis: a retrospective case-control analysis.
abstract: Objectives. Esophageal carcinoma and cirrhosis have the overlapping etiologic factors. Methods. In a retrospective analysis conducted in 2 Breton institutions we wanted to asses the frequency of this association and the outcome of these patients in a case-control study where each case (cirrhosis and esophageal cancer) was paired with two controls (esophageal cancer). Results. In a 10-year period, we have treated 958 esophageal cancer patients; 26 (2.7%) had a cirrhosis. The same treatments were proposed to the 2 groups; cases received nonsignificantly different radiation and chemotherapy dose than controls. Severe toxicities and deaths were more frequent among the cases. At the end of the treatment 58% of the cases and 67% of the controls were in complete remission; median and 2-year survival were not different between the 2 groups. All 4 Child-Pugh B class patients experienced severe side effects and 2 died during the treatment. Conclusions. This association is surprisingly infrequent in our population! Child-Pugh B patients had a dismal prognosis and a bad tolerance to radiochemotherapy; Child-Pugh A patients have the same tolerance and the same prognosis as controls and the evidence of a well-compensated cirrhosis has not modified our medical options.
authors.affiliation: Department of Medical Oncology, Centre Eugène Marquis, CS 44229, 35042 Rennes Cedex, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Trivin
authors.forename: Eveline
authors.initials: E
authors.lastname: Boucher
authors.forename: Elodie
authors.initials: E
authors.lastname: Vauléon
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cumin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Le Prisé
authors.forename: Odile
authors.initials: O
authors.lastname: Audrain
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul