2038 - Early Experience and Impact of Curative-Intent Treatment on Esophageal Cancer Outcomes in a Newly Established Tertiary Cancer Centre in North India
Presenter(s)
A. K. Choubey1, S. Pradhan2, A. Mukherji2, S. S. Nanda3, S. Jain4, S. C. Tripathi5, and A. K. Singh5; 1Associate Professor, Homi BHABHA CANCER HOSPITAL & MAHAMANA PANDIT MADAN MOHAN MALVIYA CANCER CENTRE, VARANASI, India, 2Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, India, 3Homi Bhabha Cancer Hospital, VARANASI, India, 4HOMI BHABHA CANCER HOSPITAL & MAHAMANA PANDIT MADAN MOHAN MALVIYA CANCER CENTRE, VARANASI, India, 5Homi Bhabha Cancer Hospital & Mahamana Pandit Madan Mohan Malviya Cancer Centre, VARANASI, India
Purpose/Objective(s):
Esophageal cancer is a highly debilitating disease associated with significant morbidity and poor survival outcomes. Early diagnosis and prompt initiation of curative treatment—tailored to tumor stage, histology, and patient fitness—through surgery and/or chemoradiation can prevent disease progression and improve survival while preserving quality of life. This audit evaluated outcomes of curative treatments at a tertiary care center in North India since its inception.
Materials/Methods:
A retrospective audit was performed to evaluate disease patterns and survival outcomes of non-metastatic esophageal cancer patients treated with curative intent between May 2018 and March 2025. Data collected included demographics, tumor characteristics, treatment modality (definitive chemoradiation or neoadjuvant chemoradiation/ chemotherapy followed by surgery), treatment compliance, acute and late toxicities, recurrence patterns, progression-free survival (PFS), and overall survival (OS). Survival outcomes were estimated using the Kaplan–Meier method.
Results:
Data of 230 patients were analyzed (median age 62 years; 58% male). 208 (90.4%) patients completed the planned treatment. Squamous cell carcinoma and adenocarcinoma constituted 95% (197) and 05% (11) of the cases, respectively. Majority of cases were locoregionally advanced with middle third being the commonest site, Definitive chemoradiation was delivered in 69% of patients, while 31% received neoadjuvant chemotherapy or chemoradiation followed by surgery. Grade =3 acute toxicities occurred in 10.4% cases, most commonly esophagitis and hematologic toxicity with a higher frequency in post-neoadjuvant chemotherapy cases. Among surgically treated patients, R0 resection was achieved in 85%. At a median follow-up of 27 months, 2-year PFS and OS were 52% and 68%, respectively. Locoregional and distant recurrences occurred in 09% and 07% of patients. Survival outcomes improved over a period with reduced surgical morbidity and better quality of life post treatment.
Conclusion:
Curative-intent chemoradiation with or without surgery demonstrated acceptable toxicity and encouraging survival in routine clinical practice. Survival data improved as the institute grew older with more experienced personnel and improved health infrastructure. Regular institutional audits can help benchmark outcomes and guide protocol refinement to improve multidisciplinary care delivery.