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Prognosis and survival for esophageal cancer
If you have esophageal cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as their age or overall health) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic factors for esophageal cancer.
The most important prognostic factor for esophageal cancer is the stage of the tumour at the time it is diagnosed. Esophageal cancer found at an earlier stage has a better outcome than esophageal cancer found at a later stage.
Esophageal tumours that are found only in the mucosa lining the esophagus have a more favourable prognosis than tumours that have grown through the muscle wall or that have spread to other organs.
Small tumours have a more favourable prognosis than large tumours.
Cancer has spread to lymph nodes
The lower the number of lymph nodes that have cancer, the better the prognosis.
Cancer has spread to distant organs
Esophageal cancer that has spread to organs in other parts of the body has a less favourable prognosis.
Complete surgical removal of the cancer
The amount of cancer that remains after surgery is called residual disease. No residual disease has a better prognosis than if some cancer remains after surgery.
Cancer that responds to neoadjuvant therapy
Esophageal cancer that responds to neoadjuvant therapy is more likely to be completely removed by surgery. As a result, cancer that responds to neoadjuvant therapy has a better prognosis than cancer that doesn’t respond to it.
Treatment given to shrink a tumour before the first-line therapy (the first or standard treatment), which is usually surgery.
Neoadjuvant therapy may be given if a tumour is too large to be removed by surgery. It may include chemotherapy, radiation therapy or hormone therapy.