Stage IV Esophageal Cancer: Room for Improvement? | ScholarDeck

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Stage IV Esophageal Cancer: Room for Improvement?

New research · Thoracic Surgery

Journal of laparoendoscopic & advanced surgical techniques. Part A · 10h

Cohort studyJournal of laparoendoscopic & advanced surgical techniques. Part A· Sep 2026

Stage IV Esophageal Cancer: Room for Improvement?

Pamela Milito, Stefano Siboni, Serena Grimaldi … Emanuele Asti

Esophageal SurgeryCohort studyQ3IF 1.2

Median survival much longer for stage IV-A than stage IV-B esophageal cancer after surgery

Stage IV Esophageal Cancer: Room for Improvement?

Pamela Milito … Emanuele Asti

Journal of laparoendoscopic & advanced surgical techniques · Sep 2026 · Q3 in Surgery

Background

Esophageal cancer has a very poor prognosis in advanced stages, with 5-year survival rates below 6% in stage IV disease.

Purpose

This study aimed to assess short- and long-term outcomes in patients undergoing surgery for pathological stage IV esophageal cancer.

Methods

Were divided into stage IV-A ( n = 39) and stage IV-B ( n = 21), all of whom were oligometastatic according to the OMEC classification.

n = 39

Results

IV-A patients lived more than twice as long after surgery

Stage IV-A

18months

Stage IV-B

8months

More results

Median age was 63.5 years, and 61.7% of patients were male.

Postoperative morbidity was 43.3%, and in-hospital mortality rate of 5%, showing no significant differences between groups.

Among stage IV-B patients, survival differed according to metastatic site, with better outcomes in nodal-only disease.

“

Conclusion

Esophagectomy may be feasible in highly selected stage IV patients, offering meaningful survival in stage IV-A cases, while outcomes in stage IV-B remain limited and influenced by metastatic pattern.

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