The risk of distant organ metastasis and survival analysis in esophageal cancer with different histological subtypes

The impact of histological subtypes on distant organ metastasis remains insufficiently elucidated in patients with esophageal cancer. This study aims to discuss the risk of distant organ metastasis and its effect on survival in esophageal cancer patients.

Patients with esophageal cancer, including adenocarcinoma (AC), squamous cell carcinoma (SCC), adenosquamous carcinoma (ASC), neuroendocrine carcinoma (NECS), and signet-ring cell carcinoma (SRCC), were selected from the SEER database. Logistic regression was employed to assess the risk of esophageal cancer metastasis to various organs, while Cox proportional hazards regression, Kaplan-Meier curves and the Log-rank test was used for survival analysis.

Compared to AC, patients with SCC exhibit a lower risk of developing bone, brain, and liver metastases, SRCC have a reduced risk of brain, liver, and lung metastases, and NECS are more likely to develop liver metastasis. Among patients with bone and lung metastases, those with SRCC or SCC experience poorer survival. SRCC is associated with worse prognosis in cases of brain metastasis, while SCC predicts inferior outcomes in liver metastasis. Among patients with AC or SCC, those with lung metastasis demonstrate better survival compared to those with bone or liver metastases.

In patients with esophageal cancer, organ-specific metastasis and post-metastatic survival are histology-dependent. Among the two most common histological types, AC and SCC, SCC shows a lower risk of distant metastasis. However, once metastasis occurs, patients with SCC have poorer survival compared to those with AC.