Background/Objectives:Synchronous oligometastasis in stage IVB esophageal squamous cell carcinoma (ESCC) may represent an intermediate state in which local therapy remains effective. However, its definition is still debated, and outcome data are limited.Methods:We retrospectively analyzed 191 consecutive patients with ESCC and synchronous oligometastases treated between 2006 and 2022. Oligometastasis was defined as ≤5 distant metastatic lesions. Patients received systemic therapy (chemotherapy and/or immunotherapy), local therapy (surgery or radiotherapy), or combined systemic and local therapy (surgery following preoperative therapy or chemoradiotherapy). Survival outcomes and prognostic factors were assessed.Results:The median overall survival (OS) was 25.1 months, with a 3-year OS rate of 41.0%. Multivariate analysis identified performance status, number of organ metastases, and treatment type as independent prognostic factors. Patients with single-organ metastasis had superior outcomes compared with those with multiple metastases (3-year OS: 44.3% vs. 0%; progression-free survival [PFS]: 23.5% vs. 0%). Combined systemic and local therapy yielded the best outcomes, with 3-year OS and PFS rates of 49.8% and 29.3%, respectively, compared with 20.0% and 18.1% for local therapy and 20.1% and 0% for systemic therapy alone.Conclusions:Patients with multiple-organ metastases have a very poor prognosis, indicating that their metastases may not represent true oligometastases. Long-term survival can be achieved in some patients using multimodal strategies that integrate systemic and local therapies. These findings demonstrate better treatment outcomes for stage IVB ESCC and provide a reference for future developments relating to oligometastatic disease.
背景/目的：IVB期食管鳞状细胞癌（ESCC）的同步寡转移可能代表一种局部治疗仍有效的中间状态。然而，其定义仍存在争议，且预后数据有限。 方法：我们回顾性分析了2006年至2022年间连续收治的191例伴有同步寡转移的ESCC患者。寡转移定义为远处转移病灶≤5个。患者接受了全身治疗（化疗和/或免疫治疗）、局部治疗（手术或放疗）或全身联合局部治疗（术前治疗后手术或放化疗）。评估了生存结局及预后因素。 结果：中位总生存期（OS）为25.1个月，3年OS率为41.0%。多因素分析显示体能状态、转移器官数目和治疗类型是独立的预后因素。单器官转移患者的预后优于多器官转移患者（3年OS：44.3% vs. 0%；无进展生存期[PFS]：23.5% vs. 0%）。全身联合局部治疗获得了最佳结局，其3年OS率和PFS率分别为49.8%和29.3%，而局部治疗分别为20.0%和18.1%，单纯全身治疗分别为20.1%和0%。 结论：多器官转移患者预后极差，提示其转移可能并非真正的寡转移。通过整合全身与局部治疗的多模式策略，部分患者可实现长期生存。这些发现表明IVB期ESCC可获得更好的治疗结局，并为未来寡转移疾病的相关进展提供了参考。
肿瘤(癌症)患者之家