KEY TAKEAWAYS
- The study aimed to investigate the prognostic differences between single BM and single LM in patients with mEAC.
- Researchers noted that BM in mEAC leads to worse prognosis than LM, underscoring the value of surgical and chemotherapy interventions.
Half of the patients diagnosed with esophageal cancer present with metastasis at the time of initial diagnosis. However, there is limited research focused on the prognostic factors associated with metastatic esophageal adenocarcinoma (mEAC).
Xinglian Zhu and the team aimed to examine the impact of single bone metastasis (BM) and single liver metastasis (LM) on the prognosis of patients with mEAC.
They performed an inclusive analysis using data obtained from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program database. Patients with mEAC were evaluated to compare the effects of LM and BM on overall survival (OS), EAC-specific survival (CSS), and esophageal adenocarcinoma-specific death (EASD). This was accomplished through multivariate Cox regression, Kaplan-Meier analysis, and competing risk regression models.
About 1,278 patients with EAC were included in this study. Of these, 78.95% (1009/1278) experienced EASD, while 12.68% (162/1278) had non-EAC-specific death (non-EASD). In the multivariate Cox regression analysis, surgery, chemotherapy, and AJCC stage T2 (vs. T1) were identified as protective factors for OS and EAC-specific survival (CSS).
Conversely, being divorced or separated, single or unmarried (vs. married), having grade III-IV tumors (vs. grade I-II), and BM (vs. LM) were recognized as risk factors. Competing risk regression analysis further confirmed that surgery and chemotherapy provided benefits for patients with metastatic EAC, while BM (vs.LM) remained a significant risk factor when accounting for competitive risk events.
The study concluded that patients with mEAC who have BM experience a worse prognosis compared to those with LM. Additionally, it was found that surgical intervention and chemotherapy serve as protective factors for patients with mEAC. These findings provide crucial evidence-based insights for clinical management and contribute significantly to the field.
The study was funded by the National Key Research and Development Program of China.
Source: https://pubmed.ncbi.nlm.nih.gov/39321194/
Zhu X, Mo M, Zheng S, et al. (2024). “Comparing the prognosis of esophageal adenocarcinoma with bone and liver metastases: A competing risk analysis.” PLoS One. 2024;19(9):e0303842. Published 2024 Sep 25. doi:10.1371/journal.pone.0303842
