MULTIMODAL TREATMENT OF PATIENTS WITH UPPER ESOPHAGEAL CANCER

Kirkilevsky S.I., Krahmalyov P.S., Kondratsky Y.N., Frydel R.I., Zhukov Y.O.

• National Cancer Institute, Kyiv, Ukraine

Upper esophageal cancer (UEC) accounts for 10–15% of all esophageal cancer cases and has a poor prognosis. The results of treatment of patients with UEC are still unsatisfactory. Mostly patients receive independent radiochemotherapy (RCT). Surgical interventions are rarely performed in specialized medical institutions. There is no clear algorithm for complex treatment. Aim: to improve the immediate and long-term results of the treatment of patients with UEC using the developed multimodal method of treatment. Object and methods: the direct and long-term results of treatment of 44 patients with UEC (core group) were analyzed by the developed complex method with the use of pre-ope­rative RCT with selective introduction of cytostatics and surgical intervention in the volume of one-time subtotal esophagoectomy. Comparison was made with the results of treatment of 187 patients with middle esophageal cancer (MEC) (comparison group) and 58 patients with UEC receiving independent RCT (control group). Results: the immediate results of treatment of patients with UEC by the developed method of complex treatment were assessed as satisfactory and identical to the complex treatment of patients with MEC. When evaluating long-term results of treatment, we can say that the overall survival of patients with UEC and MEC at different observation periods within 60 months after treatment was not significantly different. Long-term results in patients with UEC, who received comprehensive treatment by the developed method, were significantly better than in patients in the control group. Conclusions: the use of the developed method for multimodal treatment in patients with UEC is justified. The results of treatment of patients with UEC by the developed method of complex treatment were evaluated as satisfactory and identical to the treatment of patients with MEC. The method allows for radical treatment of patients with UEC, whose long-term results significantly exceed those after applying only conservative treatment.