IMPACT OF CLINICOPATHOLOGICAL PARAMETERS ON PATIENT - SURVIVAL IN CARCINOMA OF THE CERVICAL ESOPHAGUS

BACKGROUND: The survival of patients with carcinoma of the cervical es ophagus remains poor in spite of multimodality treatment and technical improvements in surgical resection and reconstruction, This study was undertaken to update our experience with cervical esophageal carcinom a and to identify factors that had an impact on patient survival and q uality of life. PATIENTS AND METHODS: Clinical data encompassing 132 v ariables were collected on 67 patients with cervical esophageal carcin oma from 1980 to 1993, Statistical analysis was performed: independent Student's t-tests, Cox regression, Kaplan-Meier curves, and log rank analyses were used in the statistical evaluation, The mean age of the patients was 63 years (range 31 to 88), Dysphagia was the primary symp tom in 86% of patients; 80% had received no prior treatment. The most common abnormal finding (21%) on physical examination was a neck mass. RESULTS: Curative resection was performed in 22 patients, 7 had palli ative procedures, and 7 were found to be inoperable at exploration and received palliative treatment, Radiation with or without chemotherapy was definitive treatment for 10 patients, whereas 4 patients were tre ated with chemotherapy alone for cure, and 17 patients received pallia tive treatment, The mean survival following diagnosis was 17 months (r ange 1 to 96), Cumulative 5-year survival was 12%. CONCLUSIONS: Persis tent disease, chemotherapy prior to presentation, and chemotherapy for cure remained as statistically significant parameters associated with decreased survival by multivariate analysis, There was a trend toward improved survival in patients treated with surgical resection.