Efficacy evaluation of rescue treatment for 218 patients with recurrent esophageal cancer after radical resection

Abstract

Objective To evaluate the efficacy of rescue treatment for recurrent esophageal cancer after radical esophagectomy, and to provide insights into the development of comprehensive treatment for esophageal cancer. Methods The clinical data of 218 patients who were confirmed with recurrent metastatic esophageal cancer after R0 resection and received rescue treatment in our hospital from 2004 to 2014 were retrospectively reviewed. The survival rate was determined by the Kaplan-Meier method. Univariate and multivariate prognostic analyses were performed using the log-rank test and Cox proportional hazards model, respectively. Results The median post-recurrence follow-up time was 53 months. The 1-and 3-year overall survival (OS) rates after recurrence were 57.2% and 24.4%, respectively. Among the 163 patients with local recurrence, the 1-and 3-year OS rates were 70% and 42% for patients treated with chemoradiotherapy (n=40), 55% and 24% for those with radiotherapy alone (n=106), and 23% and 8% for those with supportive therapy (n=13)(chemoradiotherapy vs. radiotherapy alone P=0.045, radiotherapy alone vs. supportive therapy P=0.004; none of the patients who were treated with chemotherapy alone survived for one year or more). Univariate analysis showed that N staging, TNM staging, and post-recurrence rescue treatment regimen were independent prognostic factors for esophageal cancer (all P=0.001). On the other hand, multivariate analysis indicated that only rescue treatment regimen was the independent prognostic factor for esophageal cancer (P=0.013). Conclusions Rescue chemoradiotherapy or radiotherapy alone can bring significant survival benefits for patients with recurrent and metastatic, especially locally recurrent, esophageal cancer following radical esophagectomy. Key words: Neoplasms recurrence, esophageal/radiotherapy; Neoplasms recurrence, esophageal/chemoradiotherapy; Combined treatment; Prognosis