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Late Recurrence After Radical Resection of Esophageal Cancer

World Journal of Surgery volume 40, pages 913–920 (2016)Cite this article

Abstract

Background

Approximately 10–20 % of esophageal cancer patients in whom recurrence is diagnosed experience late recurrence beyond 2 years after esophagectomy. However, the risk of late recurrence is still unclear. The aim of this study was to identify the risk factors of late recurrence for appropriate postoperative surveillance.

Methods

A total of 447 patients underwent radical esophagectomy and reconstruction for esophageal cancer from 2005 to 2014. Patients who had recurrence beyond 2 years after esophagectomy were defined as the late recurrence group and the remaining patients with recurrence as the early recurrence group. A comparison of the clinicopathological factors and prognosis was performed between patients with early recurrence, late recurrence, and no recurrence.

Results

Recurrences were recognized in 117(26.2 %) of the 447 patients. Recurrence was diagnosed within 2 years after surgery in 103 patients (88.0 %) and after 2 years in 14 patients (12.0 %). Patients with late recurrence showed a favorable prognosis compared with those with early recurrence (P = 0.0131), and late recurrence was an independent factor associated with a favorable prognosis after recurrence (HR 0.199, P = 0.025). In the comparison between patients with late recurrence and those with no recurrence who had a minimal recurrence-free survival of 2 years, pathological lymph node metastasis at esophagectomy was found to be an independent predictor of late recurrence (HR 7.296, P = 0.043).

Conclusions

Pathological lymph node metastasis at esophagectomy is a risk factor of late recurrence for esophageal cancer, and a close, lifelong follow-up is recommended for such patients.

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Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Yukiharu Hiyoshi, Naoya Yoshida, Junji Kurashige, Ryuichi Karashima, Shiro Iwagami, Yoshifumi Baba & Hideo Baba

  2. Esophageal Surgery, Gastroenterological Surgery, Gastroenterology Center, The Cancer Institute Hospital of JFCR (Japanese Foundation for Cancer Research), Tokyo, Japan

    Masayuki Watanabe

Authors
  1. Yukiharu Hiyoshi
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  2. Naoya Yoshida
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  3. Masayuki Watanabe
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  4. Junji Kurashige
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  5. Ryuichi Karashima
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  6. Shiro Iwagami
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  7. Yoshifumi Baba
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  8. Hideo Baba
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Correspondence to Hideo Baba.

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Hiyoshi, Y., Yoshida, N., Watanabe, M. et al. Late Recurrence After Radical Resection of Esophageal Cancer. World J Surg 40, 913–920 (2016). https://doi.org/10.1007/s00268-015-3334-8

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  • DOI: https://doi.org/10.1007/s00268-015-3334-8

Keywords

  • Esophageal Cancer
  • Favorable Prognosis
  • Early Recurrence
  • Late Recurrence
  • Esophageal Cancer Patient