Abstract
Esophageal cancer (EC) is an aggressive disease that is associated with a poor prognosis. Since metastastic EC is usually considered suitable only for palliative therapy with an estimated 5-year overall survival (OS) less than 5%, the optimal management of patients with liver oligometastatic EC (LOEC) is still undefined. The aim of this review is to provide an overview of the different treatment options for LOEC. A literature search was conducted using PubMed, Embase, and Cochrane to identify articles evaluating different treatment strategies for LOEC. Among 828 records that were identified, 20 articles met the inclusion criteria. These studies included patients who have undergone any type of surgical procedure and/or loco-regional therapy. Liver resection resulted in the best survival for patients with low tumor burden (3 lesions): 5-year OS 30–50% versus 8–12% after only chemotherapy (CHT). The 5-year OS of loco-regional therapies was 23% with a local recurrence risk ranging 0–8% for small lesions (2 to 3 cm). An aggressive multidisciplinary approach for LOEC patients may improve survival. Surgery seems to be the treatment of choice for resectable LOEC. If unfeasible, loco-regional therapies may be considered. In order to better select these patients and offer a chance of cure, prospective trials and a definition of treatment protocols are needed.
Highlights
Over the last twenty years, the incidence of esophageal cancer (EC) has rapidly increased with approximately half a million new cases each year [1]
EC still represents an aggressive disease that is associated with a poor prognosis [2,3]
The aim of this review is to provide an overview of different treatment options for oligometastatic EC (OEC)
Summary
Over the last twenty years, the incidence of esophageal cancer (EC) has rapidly increased with approximately half a million new cases each year [1]. A surgical approach combined with chemotherapy (CHT)/chemo-radiotherapy represents the preferred treatment [4,5,6]. The five-year survival rate for patients undergoing surgical resection is approaching 50% [7,8]. Patients with metastastic disease are usually considered suitable only for palliative therapy with a 5-year estimated survival less than. The liver is one of the most common sites of metastases, occurring in 35–40% of patients at the time of EC diagnosis [1,10] and it is the first recurrence site in 6–25% cases after esophagectomy [11,12,13]
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