Abstract:

Objective: Esophageal cancer is a rapidly progressive cancer. In the majority of patients local invasion or distant metastasis may be present at the time of diagnosis. The present study reviewed the records of esophageal cancer patients with hematogenous distant organ metastases with the aim of reporting primary tumor location, histological type, location of metastases, and survival rates, according to treatment administered. Method: Distant organ metastasis was detected in 50 of 316 consecutive patients that presented to the Thoracic Surgery Department of Atatürk University between 2002 and 2007. Patient age and gender, tumor location, history of esophagectomy, metastasis organ, treatment type, and survival outcome were retrospectively reviewed. Results: The liver was the most common organ of distant metastasis and was observed in 24 (38.7%) patients, followed by lung metastasis, which was observed in 21 (33.9%) patients. Bone metastases were detected in 5 patients, pancreatic metastases in 4, pleural metastases in 2, and metastasis in the spleen, peritoneum, kidney, adrenal gland, brain, and diaphragm were each observed in 1 patient. Nine patients had metastases in more than 1 organ. Overall, 6-month survival was 58%, 1-year survival was 28%, and 2-year survival was only 2%. Mean survival was 7.8 months in patients with isolated liver metastases (range: 1-18 months) versus 7.1 months (range: 2-14 months) in patients with isolated lung metastases. Mean survival was 6.2 months (range: 1-32 months) in patients with multiple organ metastases, versus 7.6 months (range: 1-18 months) in those with metastasis in 1 organ. Mean survival was 7.7 months (range: 1-18 months) in patients that received chemotherapy, as compared to 7.1 months (range: 1-32 months) in those that did not. Overall, mean survival was 7.3 months in patients with hematogenous distant organ metastases. Conclusion: Our results show that survival rates in esophageal cancer patients with distant organ metastases were similar in those that received and did not receive chemotherapy. Thus, we consider that new therapeutic protocols are required for metastases of esophagus carcinoma.

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