Patterns of recurrence after surgery and efficacy of salvage therapy after recurrence in patients with thoracic esophageal squamous cell carcinoma

被引：42

作者：

Ni, Wenjie ^{[1
]}

Yang, Jinsong ^{[2
]}

Deng, Wei ^{[3
]}

Xiao, Zefen ^{[1
]}

Zhou, Zongmei ^{[1
]}

Zhang, Hongxing ^{[1
]}

Chen, Dongfu ^{[1
]}

Feng, Qinfu ^{[1
]}

Liang, Jun ^{[1
]}

Lv, Jima ^{[1
]}

Wang, Xiaozhen ^{[1
]}

Wang, Xin ^{[1
]}

Zhang, Tao ^{[1
]}

Bi, Nan ^{[1
]}

Deng, Lei ^{[1
]}

Wang, Wenqing ^{[1
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Dept Radiat Oncol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, 17 South Panjiayuan Lane, Beijing 100021, Peoples R China

[2] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Canc Ctr, Wuhan, Hubei, Peoples R China

[3] Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing,Dept Radiat Oncol, Beijing, Peoples R China

来源：

BMC CANCER | 2020年 / 20卷 / 01期

关键词：

Esophageal neoplasm; Recurrence; Salvage treatment; Survival; LYMPH-NODE METASTASES; POSTOPERATIVE RECURRENCE; CONFORMAL RADIOTHERAPY; CURATIVE RESECTION; PROGNOSTIC-FACTORS; RADIATION-THERAPY; CANCER; CHEMORADIOTHERAPY; CHEMOTHERAPY; DELINEATION;

D O I：

10.1186/s12885-020-6622-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundInformation on the optimal salvage regimen for recurrent esophageal cancer is scarce. We aimed to assess the patterns of locoregional failure, and evaluate the therapeutic efficacy of salvage therapy along with the prognostic factors in recurrent thoracic esophageal squamous cell carcinoma (TESCC) after radical esophagectomy.MethodsA total of 193 TESCC patients who were diagnosed with recurrence after radical surgery and received salvage treatment at our hospital were retrospectively reviewed from 2004 to 2014. The patterns of the first failure were assessed. The post-recurrence survival rate was determined using the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model.ResultsThe median time of failure was 7.0months. Among the 193 patients, 163 exhibited isolated locoregional lymph node (LN) recurrence and 30 experienced locoregional LN relapse with hematogenous metastasis. Among the 193 patients, LN recurrence was noted at 302 sites; the most common sites included the supraclavicular (25.8%; 78/302) and mediastinal LNs (44.4%; 134/302), particularly stations 1 to 6 for the mediastinal LNs (36.4%; 110/302). The median overall survival (OS) was 13.1months after recurrence. In those treated with salvage chemoradiotherapy, with radiotherapy, and without radiotherapy, the 1-year OS rates were 68.5, 55.0, and 28.6%; the 3-year OS rates were 35.4, 23.8, and 2.9%; and the 5-year OS rates were 31.8, 17.2, 2.9%, respectively (P <0.001). Furthermore, patient survival in those who received salvage chemoradiotherapy was significantly better than those treated with salvage radiotherapy alone (P =0.044). Multivariate analysis showed that the pathological TNM stage and salvage treatment regimen were independent prognostic factors.ConclusionsSupraclavicular and mediastinal LN failure were the most common types of recurrence after R0 surgery in TESCC patients. Salvage chemoradiotherapy or radiotherapy could significantly improve survival in esophageal cancer with locoregional LN recurrence.

引用

页数：9

共 31 条

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