Some prognostic factors

To learn about some prognostic factors of esophageal cancer, we evaluated the results of survival after treatment, metastatic recurrence time:

4.2.1 Time to live:

- Full time to live:

The rate of survival time in 12 months, 18 months, 24 months, 36 months were respectively 92.7%, 67.6%, 48.2% and 30%. The average survival time

was 23.9 months. This result was higher than the analysis of Han Thi Thanh Binh, whole survival rate of 12 months, 24 months was 20.9% and 9.3%, the full average survival time was 8 months. A possible explanation for this difference is due to the analysis of Han Thi Thanh Binh patients only were in single radiotherapy, so the result of survival was lower than our results, patients were treated with concurrent chemotherapy treatment. According to Kaoru Ichida, overall survival entire radiotherapy, chemical and 2 years of 31.5%, while the average survival entired 10 months. Nicolas Magne took the time rate for the entire 5-year survival was 11%, the average survival time was 9.6 months.

According to Kato K, entire survival after 3 years, 5 years were respectively 44.7%, 36.8%, the average survival time was 29 months. Jean – Francois took the time rate for 1 year, 2 years, 5 years were respectively 52,9%, 29,8% and 12,1%, the average survival time was 16 months. This comment showed that the result of this analysis was similar to the foreign authors.

- Live according to tumor size:

The proportion of the average time of 12, 18, 24, 36 months of group tumor size > 5 cm were respectively 83.4%, 53.9%, 30.3% and 9%. While this ratio in group tumor size <5 cm was 94.6%, 72%, 54.1% and 37%. The average survival time of the entire group tumor size > 5 cm was 19.5 months, the group tumor size <5 cm was 29.7 months. The survival time is related to tumor size.

The bigger tumor is, the shorter this time is, this difference was statistically significant with p= 0,003. In the analysis of Hàn Thị Thanh Bình, The average survival time of tumor group <5 cm is 14 months, the tumor> 5 cm was 4.6 months. After 12 months, no patient in group > 5 cm survived and 6-month survival rate was only 30%. While survival rates after 6 months, 12 months and 24 months of patient group size u <5 cm were respectively 72.7%, 37.5% and 25.6%. This difference was statistically significant with p < 0,001. Our result was similar as Deren’s analysis when observed the perod 5-year survival of 115 patients with tumor size <5 cm to 25% higher than 6% of 504 patients with tumor size> 5 cm. According to Wang with 157 patients who had tumor size <=

3cm, 5-year survival time was 48%, median survival time was 54 months; with 425 patients who had tumor size > 3cm, 5-year survival time was 23.3% and the median survival time was 17 months, with P= 0,001.

- Live according to the histologic differentiation: Overall survival of 12 months, 18 months, 24 months and 36 months of the histological group 2 were respectively 92.8%, 69.8%, 51% and 32.2%, while this rate in groups 3 was 93.3% histology, 43.2%, 31.9% and 10.6%. he difference between the histological and cell survival had statistical significance with p = 0,01.

- Survival according to stages:

Stage of the disease is an important prognostic factor in cancer of the esophagus, thereby deciding treatment strategies. Survival rates of 12, 18, 24, 36 months in the group stage III study of patients was respectively 93.4%, 70.9%, 50.6%, 33.3%, this rate in group stage IV was 88.9%, 48.1%, 35.1% and 11.7%.

The higher stage of disease duration shorter survival, this difference was statistically significant with p=0,05. Ishikura S observed 139 patients with esophageal cancer in chemotherapy and radiotherapy CF chemicals regimens and total dose 60Gy radiation, give the results for the entire 3-year survival, 5 years corresponding to stage III was 55%, 49% and median survival time was 44 months, stage IVa was respectively 22%, 13%, with a time of living average 11 months, the difference was statistically significant. According to Nomura M with the concurrent chemotherapy treatment for 301 patients with squamous carcinoma of the esophagus , survival for the entire 3-year stage III, IVa, IVb was 37.1%, 34.2%, 9.1%, a significant difference.

- Time to live according to the response after the end of treatment

Shelf Life: 12, 18, 24, 36 months of complete response group was respectively 97.4%, 94%, 86.7% and 70.5%, partial response group was 95.3% , 70.2%, 40.1% and 11.6%. While tsurvival 12, 18 months of treatment response group was 70.6% and 5.9%, 12-month survival of the group was 33.3%

progressive disease. The result showed us that if the patient response to treatment as they add more and more time living, this association has

significantly with p< 0,001. According to Hurmuzlu M time 2-year overall survival in group meets 31%, and 6% did not respond; 3-year overall survival of 24% in the group met and not responded the group is 0%; 5-year survival in the entire group was 17% and responded the group does not responded the 0%, with P < 0,001. According to Ishikura survival entire 3 years, 5 years of complete response group was 63%, 52%; group also responded respectively 6%, 2%, a significant difference.

- Multivariate analysis of factors affecting survival

We had multivariate analysis of data from the univariate analysis as mentioned above in the patients was studied using Cox regression analysis, we found that the independent prognostic factor when multivariate analysis of variables respectively: irradiation (95% CI: 1.008 to 2.697; p = 0.046); response after concurrent chemotherapy (95% CI: 0.745 to 78.574; p = 0.087) after treatment response (95% CI: 1.763 to 5.857; p <0.0001). However, our analysis also had limitations on the number of patients studied, as well as distribution of the group of patients and follow-up period was not long that the independent factors is limited.

4.2.2 Tumor recurrence, lymph node, metastasis and cause of death

In research, recurrence rate was 1.5% in tumors, lymph node recurrence was 1.5%, 3.0% liver metastases, lung metastases of 3.8%, 4.5% bone metastases. Common cause of death was due to exhaustion, not be accounted for 46.5% eating and vomiting blood due to broken u 30.9%.According to Li, 59 patients with squamous carcinoma of the esophagus treated with chemotherapy had 13.5% of lung metastases, bone metastases 11.5%, 5% liver metastases.