Skip to main content

Advertisement

Log in

Treatment Outcome and Prognosis of Patients with Lymph Node Recurrence of Thoracic Esophageal Squamous Cell Carcinoma After Curative Resection

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

This study aimed to assess treatment outcome and factors influencing survival after lymph node recurrence of thoracic esophageal squamous cell carcinoma (SCC) after curative resection.

Methods

A total of 207 patients who underwent curative resection of thoracic esophageal SCC between March 1999 and March 2009 were retrospectively analyzed. Of these, lymph node recurrence was observed in 45 (21.7%) patients. Twenty-nine patients received intensive treatment (radiation therapy, chemoradiotherapy, or lymphadenectomy) directed at recurrent nodes, 9 patients received chemotherapy, and 7 patients received best supportive care (BSC). Treatment outcome and prognostic factors of these patients were investigated.

Results

Patients who received intensive treatment had significantly higher survival rates after recurrence than those who received chemotherapy or BSC (P = 0.0049 and 0.0004, respectively). In univariate analysis of survival after recurrence, the number of recurrent nodes (a single node or multiple nodes), the region of recurrent nodes (limited to a single region or extended to multiple regions), and the presence of simultaneous organ recurrence (present or absent) were prognostic factors (P = 0.0004, 0.0017, and <0.0001, respectively). Multivariate analysis demonstrated that the region of recurrent nodes and simultaneous organ recurrence were independent prognostic factors (P = 0.0396 and 0.0006, respectively).

Conclusions

Our findings suggest that the region of recurrent nodes (limited to a single region or extended to multiple regions) and simultaneous organ recurrence are factors influencing survival after lymph node recurrence of thoracic esophageal SCC after curative resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150

    Article  PubMed  Google Scholar 

  2. Daly JM, Fry WA, Little AG et al (2000) Esophageal cancer: results of an American College of Surgeons Patient Care Evaluation Study. J Am Coll Surg 190:562–573

    Article  PubMed  CAS  Google Scholar 

  3. Ando N, Ozawa S, Kitagawa Y et al (2000) Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 232:225–232

    Article  PubMed  CAS  Google Scholar 

  4. Nakagawa S, Kanda T, Kosugi S et al (2004) Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg 198:205–211

    Article  PubMed  Google Scholar 

  5. Shimada H, Kitabayashi H, Nabeya Y et al (2003) Treatment response and prognosis of patients after recurrence of esophageal cancer. Surgery 133:24–31

    Article  PubMed  Google Scholar 

  6. Kunisaki C, Makino H, Takagawa R et al (2008) Surgical outcomes in esophageal cancer patients with tumor recurrence after curative esophagectomy. J Gastrointest Surg 12:802–810

    Article  PubMed  Google Scholar 

  7. Nakamura T, Ota M, Narumiya K et al (2008) Multimodal treatment for lymph node recurrence of esophageal carcinoma after curative resection. Ann Surg Oncol 15:2451–2457

    Article  PubMed  Google Scholar 

  8. Ueda Y, Shiozaki A, Itoi H et al (2006) Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep 16:1061–1066

    PubMed  Google Scholar 

  9. Akiyama H (1990) Surgery for cancer of the esophagus. Williams &Wilkins, Baltimore, pp 19–42

    Google Scholar 

  10. Watanabe H (1995) The problems of cervico-thoraco abdominal (3-field) lymphadenectomy for thoracic esophageal cancer. Ann Thorac Cardiovasc Surg 1:349–353

    Google Scholar 

  11. Shiozaki A, Yamagishi H, Itoi H et al (2005) Long-term administration of low-dose cisplatin plus 5-fluorouracil prolongs the postoperative survival of patients with esophageal cancer. Oncol Rep 13:667–672

    PubMed  CAS  Google Scholar 

  12. Sobin LH, Wittekind CH (eds) (2002) TNM Classification of malignant tumors, vol 6. Wiley-Liss, New York

    Google Scholar 

  13. Kato H, Miyazaki T, Nakajima M et al (2004) Value of positron emission tomography in the diagnosis of recurrent oesophageal carcinoma. Br J Surg 91:1004–1009

    Article  PubMed  CAS  Google Scholar 

  14. Roedl JB, Harisinghani MG, Colen RR et al (2008) Assessment of treatment response and recurrence in esophageal carcinoma based on tumor length and standardized uptake value on positron emission tomography-computed tomography. Ann Thorac Surg 86:1131–1138

    Article  PubMed  Google Scholar 

  15. Igaki H, Tachimori Y, Kato H (2004) Improved survival for patients with upper and/or middle mediastinal lymph node metastasis of squamous cell carcinoma of the lower thoracic esophagus treated with 3-field dissection. Ann Surg 239:483–490

    Article  PubMed  Google Scholar 

  16. Tachibana M, Kinugasa S, Yoshimura H et al (2005) Clinical outcomes of extended esophagectomy with three-field lymph node dissection for esophageal squamous cell carcinoma. Am J Surg 189:98–109

    Article  PubMed  Google Scholar 

  17. Law S, Wong J (2001) Two-field dissection is enough for esophageal cancer. Dis Esophagus 14:98–103

    Article  PubMed  CAS  Google Scholar 

  18. Gebski V, Burmeister B, Smithers BM et al (2007) Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol 8:226–234

    Article  PubMed  CAS  Google Scholar 

  19. Takeuchi H, Saikawa Y, Oyama T et al (2010) Factors influencing the long-term survival in patients with esophageal cancer who underwent esophagectomy after chemoradiotherapy. World J Surg 34:277–284

    Article  PubMed  Google Scholar 

  20. Minski BD, Pajak TF, Ginsberg RJ et al (2002) INT0123 (Radiation Therapy Oncology Group 94–05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 20:1167–1174

    Article  Google Scholar 

  21. Ando N, Iizuka T, Ide H et al (2003) Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study—JCOG9204. J Clin Oncol 21:4592–4596

    Article  PubMed  Google Scholar 

  22. Igaki H, Kato H, Ando N et al (2008) A randomized trial of postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). J Clin Oncol 26:15S (May 20 Suppl, Abstr 4510)

    Google Scholar 

  23. Udagawa H (2009) Chemoradiotherapy: its effectiveness, toxicity and perspective in the treatment of esophageal cancer. Ann Thorac Cardiovasc Surg 15:359–361

    PubMed  Google Scholar 

  24. Motoyama S, Kitamura M, Saito R et al (2006) Outcome and treatment strategy for mid- and lower-thoracic esophageal cancer recurring locally in the lymph nodes of the neck. World J Surg 30:191–198

    Article  PubMed  Google Scholar 

  25. Nakagawa S, Nishimaki T, Kosugi S et al (2003) Cervical lymphadenectomy is beneficial for patients with carcinoma of the upper and mid-thoracic esophagus. Dis Esophagus 16:4–8

    Article  PubMed  CAS  Google Scholar 

  26. Komatsu S, Shioaki Y, Ichikawa D et al (2005) Survival and clinical evaluation of salvage operation for cervical lymph node recurrence in esophageal cancer. Hepatogastroenterology 52:796–799

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hitoshi Fujiwara.

Additional information

T. Kosuga and A. Shiozaki contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kosuga, T., Shiozaki, A., Fujiwara, H. et al. Treatment Outcome and Prognosis of Patients with Lymph Node Recurrence of Thoracic Esophageal Squamous Cell Carcinoma After Curative Resection. World J Surg 35, 798–804 (2011). https://doi.org/10.1007/s00268-011-0978-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-011-0978-x

Keywords

Navigation