Esophagectomy is the cornerstone of the curative treatment of esophageal carcinoma. Despite this treatment, patients can suffer from locoregional or distant metastatic disease and only a very selected group of patients can be cured: mostly those with recurrence in one single organ. Brain metastases are rare after esophagectomy for cancer, but they have a serious impact on survival. Agressive treatment is often moren difficult for brain metastases compared to other metastases and some risk factors have been identified earlier. There is an impression that the incidence of brain metastases in esophageal cancer patients has increased since the introduction of neoadjuvant treatment schemes. However, this is not clear yet. A potential explanation could be that chemotherapy disturbs the blood-brain-barrier, hereby facilitating the migration of tumor cells to the brain. The purpose of this study is to retrospectively analyze the incidence and potential risk factors of brain metastases in patients who underwent esophagectomy for esophageal cancer. Patients treated between 2000 and 2019 will be included and outcome parameters are Odds Ratio for brain metastases (comparison between primary surgery and neoadjuvant treatment followed by surgery), time to recurrence and risk factors, number and characteristics of the brain metastases.
Study Type
OBSERVATIONAL
Enrollment
10,000
Surgical removal of (a part of) the esophagus and surgical reconstruction with another organ (mostly stomach, but may be colon or small bowel as well)
MD Anderson Cancer Center
Houston, Texas, United States
NOT_YET_RECRUITINGUniversitair ziekenhuis Gent
Ghent, Belgium
NOT_YET_RECRUITINGCentre Hospitalier régional Universitaire de Lille
Lille, France
NOT_YET_RECRUITINGSaint James Hospital
Dublin, Ireland
NOT_YET_RECRUITINGAmsterdam UMC
Amsterdam, Netherlands
RECRUITINGZuyderland MC
Heerlen, Netherlands
NOT_YET_RECRUITINGErasmus MC
Rotterdam, Netherlands
NOT_YET_RECRUITINGKarolinska Institutet
Stockholm, Sweden
RECRUITINGOdds ratio (OR) for brain metastasis
Odds ratio (OR) for brain metastasis compared between primary surgery and neoadjuvant treatment plus surgery, OR for different neoadjuvant treatment regimes, corrected for gender and tumor factors (histology, stage, tumor differentiation,…) .
Time frame: 1 January 2000 - 1 March 2020
Overall survival
Overall survival after diagnosis of brain metastases stratified for treatment regimens applied.
Time frame: 1 January 2000 - 1 March 2020
Time to recurrence
Time to recurrence, between incidence date of esophageal cancer and diagnosis of brainM+
Time frame: 1 January 2000 - 1 March 2020
Risk factors for single site brain metastasis
such as different neoadjuvant treatment regimes, age, gender,and tumor factors (histology, stage, tumor differentiation,…)
Time frame: 1 January 2000 - 1 March 2020
Number of brain metastases
Number of brain metastases
Time frame: 1 January 2000 - 1 March 2020
Characteristics of brain metastases
solitary/multiple; location /side in the brain; treatment) and the effects on 'OS after recurrence' (e.g. is there a significant survival benefit in patients with brainM+ if they are treated with brain-surgery and/or stereotactic radiotherapy compared to non-treated BrainM+ or palliative treatments of brainM+
Time frame: 1 January 2000 - 1 March 2020
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