512 OUTCOME OF MULTIMODAL TREATMENT FOR SOLITARY LYMPH NODE RECURRENCE OF ESOPHAGEAL CARCINOMA AFTER CURATIVE RESECTION

Abstract

Abstract Patients with esophageal squamous cell carcinoma (ESCC) often display recurrence in the solitary lymph nodes after surgery. The optimal treatment strategy for these patients has not been established. The aim of the present study was to evaluate the outcome of intensive treatment for recurrent lymph node metastasis retrospectively. Methods Of the 19 patients with solitary recurrent lymph node metastasis after curative esophagectomy between 2006 and 2015, 7 had cervical lymph node, 7 had mediastinal lymph node, and 5 had abdominal lymph node recurrence. Multimodal treatment was performed in the patients: 2 patients underwent lymphadenectomy with adjuvant therapy, and 15 received definitive chemoradiotherapy and repeated chemotherapy. The remaining 2 patients received chemotherapy. Results Survival of lymphadenectomy group tended to be better than that of other groups (p = 0.1388), and survival of the lymphadenectomy and the chemoradiotherapy groups was significantly better than that of the patients who received chemotherapy (p = 0.0209). Partial response (PR), stable disease, and progressive disease were obtained in 8 (53%), 1 (7%), and 6 (40%) patients who received chemoradiotherapy, respectively. Among chemoradiotherapy groups, patients with a therapeutic effect (PR) on radiation therapy had significantly better prognosis (p = 0.0175). Conclusion Multimodal treatment including lymphadenectomy and chemoradiotherapy could improve survival of the patients with solitary lymph node recurrence of esophageal carcinoma after curative resection.