Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the r...
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Autor*in:	Masayuki Urabe [verfasserIn] Koichi Yagi [verfasserIn] Shinichiro Shiomi [verfasserIn] Tetsuro Toriumi [verfasserIn] Yasuhiro Okumura [verfasserIn] Yasuyuki Seto [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence

Übergeordnetes Werk:	In: Journal of Chest Surgery - Korean Society for Thoracic & Cardiovascular Surgery, 2021, 55(2022), 5, Seite 397-404
Übergeordnetes Werk:	volume:55 ; year:2022 ; number:5 ; pages:397-404

Links:	Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.5090/jcs.22.031

Katalog-ID:	DOAJ007823177

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520			\|a Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.
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allfields	10.5090/jcs.22.031 doi (DE-627)DOAJ007823177 (DE-599)DOAJd80751acbe0e4771b49f30e5dfe42e73 DE-627 ger DE-627 rakwb eng R5-920 Masayuki Urabe verfasserin aut Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option. esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence Medicine (General) Koichi Yagi verfasserin aut Shinichiro Shiomi verfasserin aut Tetsuro Toriumi verfasserin aut Yasuhiro Okumura verfasserin aut Yasuyuki Seto verfasserin aut In Journal of Chest Surgery Korean Society for Thoracic & Cardiovascular Surgery, 2021 55(2022), 5, Seite 397-404 (DE-627)1751336255 27651614 nnns volume:55 year:2022 number:5 pages:397-404 https://doi.org/10.5090/jcs.22.031 kostenfrei https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 kostenfrei https://doaj.org/toc/2765-1606 Journal toc kostenfrei https://doaj.org/toc/2765-1614 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 55 2022 5 397-404
spelling	10.5090/jcs.22.031 doi (DE-627)DOAJ007823177 (DE-599)DOAJd80751acbe0e4771b49f30e5dfe42e73 DE-627 ger DE-627 rakwb eng R5-920 Masayuki Urabe verfasserin aut Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option. esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence Medicine (General) Koichi Yagi verfasserin aut Shinichiro Shiomi verfasserin aut Tetsuro Toriumi verfasserin aut Yasuhiro Okumura verfasserin aut Yasuyuki Seto verfasserin aut In Journal of Chest Surgery Korean Society for Thoracic & Cardiovascular Surgery, 2021 55(2022), 5, Seite 397-404 (DE-627)1751336255 27651614 nnns volume:55 year:2022 number:5 pages:397-404 https://doi.org/10.5090/jcs.22.031 kostenfrei https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 kostenfrei https://doaj.org/toc/2765-1606 Journal toc kostenfrei https://doaj.org/toc/2765-1614 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 55 2022 5 397-404
allfields_unstemmed	10.5090/jcs.22.031 doi (DE-627)DOAJ007823177 (DE-599)DOAJd80751acbe0e4771b49f30e5dfe42e73 DE-627 ger DE-627 rakwb eng R5-920 Masayuki Urabe verfasserin aut Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option. esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence Medicine (General) Koichi Yagi verfasserin aut Shinichiro Shiomi verfasserin aut Tetsuro Toriumi verfasserin aut Yasuhiro Okumura verfasserin aut Yasuyuki Seto verfasserin aut In Journal of Chest Surgery Korean Society for Thoracic & Cardiovascular Surgery, 2021 55(2022), 5, Seite 397-404 (DE-627)1751336255 27651614 nnns volume:55 year:2022 number:5 pages:397-404 https://doi.org/10.5090/jcs.22.031 kostenfrei https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 kostenfrei https://doaj.org/toc/2765-1606 Journal toc kostenfrei https://doaj.org/toc/2765-1614 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 55 2022 5 397-404
allfieldsGer	10.5090/jcs.22.031 doi (DE-627)DOAJ007823177 (DE-599)DOAJd80751acbe0e4771b49f30e5dfe42e73 DE-627 ger DE-627 rakwb eng R5-920 Masayuki Urabe verfasserin aut Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option. esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence Medicine (General) Koichi Yagi verfasserin aut Shinichiro Shiomi verfasserin aut Tetsuro Toriumi verfasserin aut Yasuhiro Okumura verfasserin aut Yasuyuki Seto verfasserin aut In Journal of Chest Surgery Korean Society for Thoracic & Cardiovascular Surgery, 2021 55(2022), 5, Seite 397-404 (DE-627)1751336255 27651614 nnns volume:55 year:2022 number:5 pages:397-404 https://doi.org/10.5090/jcs.22.031 kostenfrei https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 kostenfrei https://doaj.org/toc/2765-1606 Journal toc kostenfrei https://doaj.org/toc/2765-1614 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 55 2022 5 397-404
allfieldsSound	10.5090/jcs.22.031 doi (DE-627)DOAJ007823177 (DE-599)DOAJd80751acbe0e4771b49f30e5dfe42e73 DE-627 ger DE-627 rakwb eng R5-920 Masayuki Urabe verfasserin aut Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option. esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence Medicine (General) Koichi Yagi verfasserin aut Shinichiro Shiomi verfasserin aut Tetsuro Toriumi verfasserin aut Yasuhiro Okumura verfasserin aut Yasuyuki Seto verfasserin aut In Journal of Chest Surgery Korean Society for Thoracic & Cardiovascular Surgery, 2021 55(2022), 5, Seite 397-404 (DE-627)1751336255 27651614 nnns volume:55 year:2022 number:5 pages:397-404 https://doi.org/10.5090/jcs.22.031 kostenfrei https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 kostenfrei https://doaj.org/toc/2765-1606 Journal toc kostenfrei https://doaj.org/toc/2765-1614 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 55 2022 5 397-404
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source	In Journal of Chest Surgery 55(2022), 5, Seite 397-404 volume:55 year:2022 number:5 pages:397-404
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authorswithroles_txt_mv	Masayuki Urabe @@aut@@ Koichi Yagi @@aut@@ Shinichiro Shiomi @@aut@@ Tetsuro Toriumi @@aut@@ Yasuhiro Okumura @@aut@@ Yasuyuki Seto @@aut@@
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callnumber-first	R - Medicine
author	Masayuki Urabe
spellingShingle	Masayuki Urabe misc R5-920 misc esophageal neoplasms misc esophageal surgery misc liver-directed therapy misc liver metastasis misc recurrence misc Medicine (General) Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer
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topic_title	R5-920 Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer esophageal neoplasms esophageal surgery liver-directed therapy liver metastasis recurrence
topic	misc R5-920 misc esophageal neoplasms misc esophageal surgery misc liver-directed therapy misc liver metastasis misc recurrence misc Medicine (General)
topic_unstemmed	misc R5-920 misc esophageal neoplasms misc esophageal surgery misc liver-directed therapy misc liver metastasis misc recurrence misc Medicine (General)
topic_browse	misc R5-920 misc esophageal neoplasms misc esophageal surgery misc liver-directed therapy misc liver metastasis misc recurrence misc Medicine (General)
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title	Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer
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title_full	Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer
author_sort	Masayuki Urabe
journal	Journal of Chest Surgery
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author_browse	Masayuki Urabe Koichi Yagi Shinichiro Shiomi Tetsuro Toriumi Yasuhiro Okumura Yasuyuki Seto
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doi_str_mv	10.5090/jcs.22.031
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title_sort	implications of liver-directed therapy for postoperative hepatic metastasis from esophageal cancer
callnumber	R5-920
title_auth	Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer
abstract	Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.
abstractGer	Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.
abstract_unstemmed	Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.
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title_short	Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer
url	https://doi.org/10.5090/jcs.22.031 https://doaj.org/article/d80751acbe0e4771b49f30e5dfe42e73 https://doaj.org/toc/2765-1606 https://doaj.org/toc/2765-1614
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author2	Koichi Yagi Shinichiro Shiomi Tetsuro Toriumi Yasuhiro Okumura Yasuyuki Seto
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up_date	2024-07-03T14:19:44.986Z
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Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

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