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Recurrence Pattern of Squamous Cell Carcinoma in the Middle Thoracic Esophagus after Modified Ivor-Lewis Esophagectomy

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Abstract

Background

Despite increasingly radical surgery for esophageal carcinoma, many patients still develop tumor recurrence after operation. This study was designed to evaluate the recurrence pattern of squamous cell carcinoma in the middle thoracic esophagus after modified Ivor-Lewis esophagectomy.

Methods

We retrospectively reviewed data of 196 patients who underwent modified Ivor-Lewis esophagectomy with two-field lymph node dissection from January 1997 to January 2001. Recurrence was classified as locoregional or hematogenous recurrence. Logistic regression analysis was performed to identify risk factors of postoperative recurrence.

Results

The overall 3-year and 5-year survival rates in all patients were 53% and 31%, respectively. Recurrence was recognized in 96 patients (48.9%) in the 3 years after operation. The median time to tumor recurrence was 12.2 months. The pattern of recurrence was locoregional in 52 patients (mainly mediastinal in 41, single cervical/supraclavicular in 8), hematogenous in 44 patients (simultaneous locoregional and hematogenous in 10; mainly liver, bone, or lung in 39). The locoregional recurrence rate was significantly lower in patients with postoperative radiotherapy than that in patients without postoperative radiotherapy (p = 0.02). Logistic regression analysis showed that T3 (p = 0.032), N1 (p = 0.003), and postoperative radiotherapy (p = 0.022) were independent risk factors for tumor locoregional recurrence.

Conclusions

About one half of the patients would develop recurrent disease within 3 years after modified Ivor-Lewis esophagectomy with two-field lymph node dissection, and most of them had mediastinal lymph node, liver, bone, or lung metastasis. Postoperative radiotherapy was beneficial in the control of locoregional recurrence.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China

    Gang Chen MM, Zhou Wang MD, Xiang-yan Liu MD & Fan-ying Liu MB

Authors
  1. Gang Chen MM
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  2. Zhou Wang MD
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  3. Xiang-yan Liu MD
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  4. Fan-ying Liu MB
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Correspondence to Zhou Wang MD.

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Chen, G., Wang, Z., Liu, Xy. et al. Recurrence Pattern of Squamous Cell Carcinoma in the Middle Thoracic Esophagus after Modified Ivor-Lewis Esophagectomy. World J Surg 31, 1108–1115 (2007). https://doi.org/10.1007/s00268-006-0551-1

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  • DOI: https://doi.org/10.1007/s00268-006-0551-1

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