(S018) Patterns of Care and Survival Outcomes in the Treatment of Esophageal Melanoma

Publication
Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

Esophageal melanoma is an aggressive disease with very poor outcomes. Esophagectomy may result in reasonable survival for localized disease. Treatment with RT did not result in any surviving patients at 3 years.

Joseph P. Weiner, MD, Meng Shao, MD, Andrew Wong, MD, David Schwartz, MD, David Schreiber, MD; VA NY Harbor Healthcare System; SUNY Downstate Medical Center

OBJECTIVE: Esophageal melanoma is an uncommon yet aggressive disease that arises from melanocytes of the esophageal mucosa. Due to its rarity, the optimal management of this disease remains limited. The purpose of our study is to use the National Cancer Data Base (NCDB) to review the patterns of care and outcomes for this uncommon tumor.

MATERIALS AND METHODS: Patients who were diagnosed with esophageal melanoma between 1998 and 2011 were identified. Patients were stratified as either localized (T1–4N0M0), regional (T1–4N+M0), or metastatic (M1). The primary endpoint of this study was overall survival (OS), which was analyzed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards analyses were performed to identify potential factors influencing survival.

RESULTS: A total of 56 patients were identified, with a median follow-up of 10.2 months. Twenty-seven (48.2%) patients had localized disease, 10 patients (17.9%) had regional disease, and 19 patients (33.9%) were metastatic at diagnosis. For those with localized disease, the 3-year OS was 50.5% for the 14 patients treated with esophagectomy and 0.0% for the 7 treated with definitive radiation therapy (RT). For regional disease, the 3-year OS was 11.1% for the nine patients treated with esophagectomy, and the one patient who received RT died at 9 months. The 3-year OS for those with metastatic disease at diagnosis was 0.0%. On multivariate analysis, treatment with esophagectomy was not associated with a reduced risk of death (hazard ratio [HR], 0.84 [95% CI, 0.31–2.25]; P = .73), while regional disease (HR, 3.78 [95% CI, 1.40–10.19]; P = .009) and metastatic disease (HR, 7.54 [95% CI, 2.89–19.62]; P < .001) were associated with decreased survival.

CONCLUSION: Esophageal melanoma is an aggressive disease with very poor outcomes. Esophagectomy may result in reasonable survival for localized disease. Treatment with RT did not result in any surviving patients at 3 years.

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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