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Survival Factors in Patients with Recurrence After Curative Resection of Esophageal Squamous Cell Carcinomas

Annals of Surgical Oncology volume 18, pages 3353–3361 (2011)Cite this article

Abstract

Background

Approximately half of patients who undergo curative resection for esophageal cancers develop recurrence postoperatively. The factors affecting survival after such recurrence remain largely unknown.

Methods

To investigate factors affecting survival after recurrence in patients who had undergone curative resection for esophageal cancer, we retrospectively reviewed data for 461 patients who underwent curative esophagectomy with or without preoperative therapy for esophageal squamous cell carcinoma from January 1996 to December 2007. The correlations between several clinicopathological factors and survival after recurrence were examined.

Results

Recurrence occurred in 196 of 461 patients (42.5%), with a median survival time after recurrence of 8.2 months. Multivariate analysis identified advanced tumor stage, preoperative chemoradiotherapy (CRT), number of recurrent tumors, and the presence of recurrence at the local site and liver as associated with shortened survival after recurrence. The analysis also indicated that treatment of the recurrence prolonged survival regardless of the treatment type. Although the pattern of recurrence did not significantly differ according to type of preoperative therapy, patients who underwent preoperative CRT were less often treated with radiotherapy for recurrence. Patients with multiple recurrent tumors less often received radiotherapy or surgery than those with a solitary recurrence. Chemotherapy for recurrence was not associated with either preoperative therapy or the number of recurrences.

Conclusions

Our retrospective study showed that multiple recurrent tumors and preoperative CRT limit the available treatment for recurrence and thereby are associated with poor prognosis. Vigorous treatment for recurrence can extend survival after recurrence in patients who undergo esophagectomy.

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Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Hiroshi Miyata MD, Makoto Yamasaki MD, Yukinori Kurokawa MD, Shuji Takiguchi MD, Kiyokazu Nakajima MD, Yoshiyuki Fujiwara MD, Masaki Mori MD & Yuichiro Doki MD

  2. Radiation Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan

    Koji Konishi MD

Authors
  1. Hiroshi Miyata MD
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  2. Makoto Yamasaki MD
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  3. Yukinori Kurokawa MD
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  4. Shuji Takiguchi MD
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  5. Kiyokazu Nakajima MD
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  6. Yoshiyuki Fujiwara MD
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  7. Koji Konishi MD
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  8. Masaki Mori MD
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  9. Yuichiro Doki MD
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Corresponding author

Correspondence to Hiroshi Miyata MD.

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Miyata, H., Yamasaki, M., Kurokawa, Y. et al. Survival Factors in Patients with Recurrence After Curative Resection of Esophageal Squamous Cell Carcinomas. Ann Surg Oncol 18, 3353–3361 (2011). https://doi.org/10.1245/s10434-011-1747-7

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  • DOI: https://doi.org/10.1245/s10434-011-1747-7

Keywords

  • Esophageal Cancer
  • Esophageal Squamous Cell Carcinoma
  • Recurrent Disease
  • Curative Resection
  • Preoperative Chemotherapy