Treatment pattern and overall survival in squamous cell carcinoma of the esophagus over two decades: A single institutional experience

Abstract

Introduction: Kashmir Valley of India lies at the edge of the “Asian esophageal cancer belt.” A number of treatment modalities have been delivered to the patients of esophageal squamous cell carcinoma at our Regional Cancer Centre. We considered it worthwhile to analyze the outcome of all these modalities. Materials and Methods: In the Department of Radiation Oncology of our institute, retrospective analysis of 2090 patients was done, who were diagnosed with nonmetastatic squamous cell carcinoma of the esophagus from 1993 to 2013. Of these 2090 cases, only 1337 patients only completed the treatment. Seven hundred and fifty-three patients either did not report for treatment after registration or did not complete the treatment. These 1337 patients were reviewed in terms of dysphagia relief, local disease control, distant metastasis, and overall survival (OS) at 1 and 2 years. They were grouped into 14 different groups as per the treatment received from A to N. Results: Fourteen different treatment modalities have been used at our center from 1993 to 2013. The overall percentage of local recurrence was 14.95%, highest being in Group L (26.65) and nil in Group M. About 32.57% of patients developed distance metastasis, highest (50%) in Group J, and nil in Group M. The most common site of failure was the supraclavicular nodes (7%), followed by the bone, liver, lung, and brain. OS at 1 and 2 years was 51.86% and 20.55%, respectively. However, it could not designate any particular modality as the best for treating patients with squamous cell carcinoma of the esophagus. Conclusion: We concluded from our study that the most common failure in squamous cell carcinoma esophagus is the distant metastasis. Local recurrences are least in patients who underwent surgery. Unfortunately, we could not point out a single group from the study which could be deemed as the best treatment modality for carcinoma esophagus.