From the Guidelines
The life expectancy for esophageal cancer that has spread to both the lungs and liver is generally around 9 months, as indicated by a study comparing different chemotherapy regimens for advanced or metastatic esophageal cancer 1. When considering the prognosis for patients with esophageal cancer that has metastasized to the lungs and liver, several factors come into play, including the patient's overall health, age, and the specific characteristics of the cancer.
- The extent of metastatic disease is a critical factor, with more widespread disease generally indicating a poorer prognosis.
- The type of esophageal cancer, whether adenocarcinoma or squamous cell carcinoma, can also influence outcomes, as seen in a study where median survival was 20 months for patients with adenocarcinoma and 10 months for those with squamous cell carcinoma 1.
- Treatment approaches, including combination chemotherapy regimens like FOLFIRI, which has been shown to be less toxic and better tolerated than other regimens like ECF 1, can impact survival and quality of life.
- Palliative care plays a significant role in managing symptoms and improving quality of life for these patients, as indicated by studies showing that while chemotherapy may not provide a significant survival benefit, it can improve quality of life in patients with metastatic or unresectable esophageal cancer 1. Given the aggressive nature of esophageal cancer and the impact of metastases on vital organ function, the prognosis remains poor, with treatment focusing on extending survival and improving quality of life rather than achieving a cure.
- Current evidence suggests that the most effective approach involves a combination of palliative care and chemotherapy, with the choice of regimen depending on individual patient factors and the specific characteristics of the cancer.
- The use of targeted therapies and immunotherapies may also offer potential benefits for eligible patients, although more research is needed to fully understand their role in the treatment of advanced esophageal cancer.
From the Research
Life Expectancy of Esophageal Cancer
- The life expectancy of esophageal cancer patients once it spreads to lungs and liver is generally poor, with a 5-year survival rate of less than 5% 2.
- A study found that the one-year survival rate for stage IV esophageal cancer patients was 25.6%, with a median survival time of 8 months 2.
- The prognosis of metastatic esophageal cancer is affected by several factors, including age, site of primary tumor, grade of primary tumor, T classification, ECOG PS, site of metastasis, and number of metastasis 2.
Treatment Options
- Treatment of metastatic esophageal cancer is essentially palliative and based on chemoradiotherapy 3.
- A case study reported a sustained complete response in a patient with esophageal squamous cell cancer and a solitary liver metastasis, treated with irinotecan and cisplatin combination chemotherapy, nimotuzumab targeted therapy, and stereotactic Gamma Knife radiosurgery 3.
- Liver resection of metastases from esophageal cancer combined with neoadjuvant and adjuvant chemotherapy may be feasible in selected patients, but further research is required to determine whether this can offer a survival advantage 4.
Chemotherapy Regimens
- Cisplatin and 5-fluorouracil (5-FU) is a commonly used chemotherapy regimen for esophageal cancer, with a median survival of 17.8 months and a partial or complete response rate of 42% 5.
- A study compared the efficacy and toxicity of cisplatin/5-FU and carboplatin/paclitaxel chemoradiotherapy regimens, finding that carboplatin/paclitaxel was associated with decreased weight loss and improved pathologic response, but no difference in overall survival or progression-free survival 6.