Abstract
Objective To compare the prognosis of patients with squamous cell carcinoma of the upper thoracic esophagus after radical resection with and without postoperative chemoradiotherapy (POCRT). Methods From January 2007 to December 2011, 168 patients with upper thoracic esophageal carcinoma who were treated in the Fourth Hospital of Hebei Medical University were retrospectively included in this study. According to the different treatment method, they were divided into simple surgery group (86 cases) and POCRT group (82 cases) respectively. Based on SPSS statistical software, the group data composition, prognostic analysis and multivariate prognostic analysis were performed by χ2 test, Log-rank method and Cox regression model, respectively. Results The 1, 3, 5 year- survival rate, recurrence rate and distant metastasis rate were 83.9%, 52.4%, 43.5%, 26.5%, 40.8%, 43.4% and 5.3%, 11.4%, 16.9%, respectively. The result of multivariate analysis showed that gender, T stage, N stage and treatment method were independent prognostic factors of overall survival (P=0.020, 0.008, 0.005, 0.000); N staging and treatment method were the independent prognostic factors of local/regional recurrence (P=0.001, 0.003); differentiation and T staging were the independent prognostic factors of distant metastasis (P=0.045, 0.020). The intrathoracic regional recurrence rate of operation only group and POCRT group patients were 44.2% (38/86) and 29.3% (24/82) respectively, where the difference was statistically significant (χ2=7.110, P 0.05). Conclusions The recurrence rate of patients with upper thoracic esophageal squamous cell carcinoma after radical resection was still high. Postoperative chemoradiotherapy can improve the overall survival rate and reduce the recurrence rate, but whether it can reduce the patient′s distant metastasis rate needs further study. Key words: Esophageal neoplasms/Esophageal squamous cell carcinoma; Upper thoracic region; Surgical treatment; Postoperative chemoradiotherapy; Prognosis
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