Abstract
BackgroundDespite increasingly radical surgery for esophageal carcinoma, many patients still develop tumor recurrence after operation. This study was designed to analyze the clinical and pathologic influencing factors of early recurrence in patients with histological node-negative (pN0 stage) esophageal squamous cell carcinoma (ESCC) after radical esophagectomy.MethodsA retrospective study on 112 consecutive pN0 stage ESCC patients who underwent esophagectomy with lymphadenectomy by the same surgical team from January 2004 to December 2010. There were 92 male and 20 female patients, aging from 36 to 80 years with a mean age of 60.3 years. The Cox proportional hazards model was used to determine the independent risk factors for recurrence within 3 years after the operation.ResultsRecurrence was recognized in 45 patients (40.2%) within 3 years after operation. The median time to tumor recurrence was 17.4 months. Locoregional recurrence was found in 38 patients (33.9%) and hematogenous metastasis in 7 patients (6.3%). However, locoregional recurrence accounted for 84.4% of all relapse patients. Recurrence closely correlated with tumor location, grade of differentiation, primary tumor stage (pT) and pathologic stage (χ2 = 6.380 to 18.837, p < 0.05). The Cox multivariate analysis showed that upper/middle thoracic location (OR = 1.092, p = 0.049) and pT3-4a stage (OR = 3.296, p = 0.017) were independent risk factors for postoperative locoregional recurrence.ConclusionLocoregional recurrence was the most common recurrence pattern of patients with pN0 ESCC within 3 years after operation. Upper/middle thoracic location and pT3-4a stage were independent risk factors for locoregional recurrence of pN0 ESCC after radical esophagectomy.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0150-4) contains supplementary material, which is available to authorized users.
Highlights
Despite increasingly radical surgery for esophageal carcinoma, many patients still develop tumor recurrence after operation
In China, the predominant pathologic type of esophageal carcinoma is squamous cell carcinoma (ESCC), and many tumors locate in the middle thoracic
The overall 5-year survival rate of patients with lymph node metastasis (LNM) after surgical resection was only about 20% [1], and most of these patients died of tumor relapse
Summary
Despite increasingly radical surgery for esophageal carcinoma, many patients still develop tumor recurrence after operation. This study was designed to analyze the clinical and pathologic influencing factors of early recurrence in patients with histological node-negative (pN0 stage) esophageal squamous cell carcinoma (ESCC) after radical esophagectomy. In China, the predominant pathologic type of esophageal carcinoma is squamous cell carcinoma (ESCC), and many tumors locate in the middle thoracic. The therapeutic efficacy for ESCC had been greatly improved due to the establishment and promotion. The purposes of this study were to explore the pattern and time of recurrence after extended radical esophagectomy with systemic lymphadenectomy, to identify the prognostic factors responsible for recurrence, and to discuss therapeutic strategies that might be helpful to decrease recurrence and improve survival
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