Management of Esophageal Carcinoma Associated with Cirrhosis : A Retrospective Case-Control Analysis

Abstract EN

Objectives.

Esophageal carcinoma and cirrhosis have the overlapping etiologic factors.

Methods.

In a retrospective analysis conducted in 2 Breton institutions we wanted to asses the frequency of this association and the outcome of these patients in a case-control study where each case (cirrhosis and esophageal cancer) was paired with two controls (esophageal cancer).

Results.

In a 10-year period, we have treated 958 esophageal cancer patients; 26 (2.7%) had a cirrhosis.

The same treatments were proposed to the 2 groups; cases received nonsignificantly different radiation and chemotherapy dose than controls.

Severe toxicities and deaths were more frequent among the cases.

At the end of the treatment 58% of the cases and 67% of the controls were in complete remission; median and 2-year survival were not different between the 2 groups.

All 4 Child-Pugh B class patients experienced severe side effects and 2 died during the treatment.

Conclusions.

This association is surprisingly infrequent in our population! Child-Pugh B patients had a dismal prognosis and a bad tolerance to radiochemotherapy; Child-Pugh A patients have the same tolerance and the same prognosis as controls and the evidence of a well-compensated cirrhosis has not modified our medical options.