Table of Contents Author Guidelines Submit a Manuscript
Journal of Oncology
Volume 2009 (2009), Article ID 173421, 5 pages
http://dx.doi.org/10.1155/2009/173421
Clinical Study

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

1Department of Medical Oncology, Centre Eugène Marquis, CS 44229, 35042 Rennes Cedex, France
2Department of Oncology, Centre Hospitalier de Bretagne Sud, 56100 Lorient, France
3Department of Radiotherapy, Centre Eugène Marquis, CS 44229, 35042 Rennes Cedex, France

Received 24 April 2009; Revised 9 September 2009; Accepted 20 October 2009

Academic Editor: David Ball

Copyright © 2009 Florence Trivin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.