Risk Factors for Esophageal Fistula Associated with Chemoradiotherapy for Locally Advanced Unresectable Esophageal Cancer

Takahiro Tsushima, Junki Mizusawa, Kazuki Sudo, Yoshitaka Honma, Ken Kato, Hiroyasu Igaki, Yasuhiro Tsubosa, Masayuki Shinoda, Kenichi Nakamura, Haruhiko Fukuda, Yuukou Kitagawa

研究成果: Article

19 引用 (Scopus)

抄録

Esophageal fistula is a critical adverse event in patients treated with chemoradiotherapy (CRT) for locally advanced esophageal cancer. However, risk factors associated with esophageal fistula formation in patients receiving CRT have not yet been elucidated. We retrospectively analyzed data obtained from 140 patients who were enrolled in a phase II/III trial comparing low-dose cisplatin with standard-dose cisplatin administered in combination with 5-flurouracil and concomitant radiotherapy. Inclusion criteria were performance status (PS) 0 to 2 and histologically proven thoracic esophageal cancer clinically diagnosed as T4 and/or unresectable lymph node metastasis for which definitive CRT was applicable. Risk factors for esophageal fistula were examined with univariate analysis using Fisher exact test and multivariate analysis using logistic regression models. Esophageal fistula was observed in 31 patients (22%). Of these, 6 patients developed fistula during CRT. Median time interval between the date of CRT initiation and that of fistula diagnosis was 100 days (inter quartile range, 45-171). Esophageal stenosis was the only significant risk factor for esophageal fistula formation both in univariate (P=0.026) and in multivariate analyses (odds ratio, 2.59; 95% confidence interval, 1.13-5.92, P=0.025). Other clinicopathological factors, namely treatment arm, age, sex, PS, primary tumor location, T stage, lymph node invasion to adjacent organs, blood cell count, albumin level, and body mass index, were not risk factors fistula formation. Esophageal stenosis was a significant risk factor for esophageal fistula formation in patients treated with CRT for unresectable locally advanced thoracic esophageal squamous cell carcinoma.

元の言語English
記事番号e3699
ジャーナルMedicine (United States)
95
発行部数20
DOI
出版物ステータスPublished - 2016 5 1

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Esophageal Fistula
Chemoradiotherapy
Esophageal Neoplasms
Fistula
Esophageal Stenosis
Cisplatin
Thorax
Multivariate Analysis
Logistic Models
Lymph Nodes
Blood Cell Count
Albumins
Body Mass Index
Radiotherapy
Odds Ratio
Confidence Intervals
Neoplasm Metastasis
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

これを引用

Risk Factors for Esophageal Fistula Associated with Chemoradiotherapy for Locally Advanced Unresectable Esophageal Cancer. / Tsushima, Takahiro; Mizusawa, Junki; Sudo, Kazuki; Honma, Yoshitaka; Kato, Ken; Igaki, Hiroyasu; Tsubosa, Yasuhiro; Shinoda, Masayuki; Nakamura, Kenichi; Fukuda, Haruhiko; Kitagawa, Yuukou.

:: Medicine (United States), 巻 95, 番号 20, e3699, 01.05.2016.

研究成果: Article

Tsushima, T, Mizusawa, J, Sudo, K, Honma, Y, Kato, K, Igaki, H, Tsubosa, Y, Shinoda, M, Nakamura, K, Fukuda, H & Kitagawa, Y 2016, 'Risk Factors for Esophageal Fistula Associated with Chemoradiotherapy for Locally Advanced Unresectable Esophageal Cancer', Medicine (United States), 巻. 95, 番号 20, e3699. https://doi.org/10.1097/MD.0000000000003699
Tsushima, Takahiro ; Mizusawa, Junki ; Sudo, Kazuki ; Honma, Yoshitaka ; Kato, Ken ; Igaki, Hiroyasu ; Tsubosa, Yasuhiro ; Shinoda, Masayuki ; Nakamura, Kenichi ; Fukuda, Haruhiko ; Kitagawa, Yuukou. / Risk Factors for Esophageal Fistula Associated with Chemoradiotherapy for Locally Advanced Unresectable Esophageal Cancer. :: Medicine (United States). 2016 ; 巻 95, 番号 20.
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abstract = "Esophageal fistula is a critical adverse event in patients treated with chemoradiotherapy (CRT) for locally advanced esophageal cancer. However, risk factors associated with esophageal fistula formation in patients receiving CRT have not yet been elucidated. We retrospectively analyzed data obtained from 140 patients who were enrolled in a phase II/III trial comparing low-dose cisplatin with standard-dose cisplatin administered in combination with 5-flurouracil and concomitant radiotherapy. Inclusion criteria were performance status (PS) 0 to 2 and histologically proven thoracic esophageal cancer clinically diagnosed as T4 and/or unresectable lymph node metastasis for which definitive CRT was applicable. Risk factors for esophageal fistula were examined with univariate analysis using Fisher exact test and multivariate analysis using logistic regression models. Esophageal fistula was observed in 31 patients (22{\%}). Of these, 6 patients developed fistula during CRT. Median time interval between the date of CRT initiation and that of fistula diagnosis was 100 days (inter quartile range, 45-171). Esophageal stenosis was the only significant risk factor for esophageal fistula formation both in univariate (P=0.026) and in multivariate analyses (odds ratio, 2.59; 95{\%} confidence interval, 1.13-5.92, P=0.025). Other clinicopathological factors, namely treatment arm, age, sex, PS, primary tumor location, T stage, lymph node invasion to adjacent organs, blood cell count, albumin level, and body mass index, were not risk factors fistula formation. Esophageal stenosis was a significant risk factor for esophageal fistula formation in patients treated with CRT for unresectable locally advanced thoracic esophageal squamous cell carcinoma.",
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AU - Sudo, Kazuki

AU - Honma, Yoshitaka

AU - Kato, Ken

AU - Igaki, Hiroyasu

AU - Tsubosa, Yasuhiro

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