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Treatment Outcomes and Prognostic Factors After Recurrence of Esophageal Squamous Cell carcinoma

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Abstract

Background

The evaluation of treatment outcomes and detection of prognostic factors after recurrence are very important for tailoring optimal therapies for individual patients with recurrent esophageal cancer.

Methods

We reviewed 133 patients in whom esophageal squamous cell carcinoma (ESCC) recurred after curative surgery, and assessed recurrence patterns, treatment outcomes and prognostic factors.

Results

Recurrence in 57 (42.9%), 54 (40.6%) and 22 (16.5%) patients was locoregional, distant and combined, respectively. The median amounts of elapsed time until recurrence and median survival after recurrence for all patients were 9.1 and 8.3 months, respectively. Univariate and multivariate analyses selected time to recurrence (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.97–0.999; p = 0.04), recurrence location (locoregional vs. distant: HR, 1.63; 95% CI, 1.03–2.61; p = 0.04), number of organs with recurrence (1 vs. 3: HR, 3.49; 95% CI, 1.23–9.87; p = 0.02) and treatment after recurrence (best supportive care, [BSC] vs. chemotherapy [CT] or radiation therapy [RT]: HR, 0.37; 95% CI, 0.15–0.94; p = 0.04; BSC vs. CT and RT: HR, 0.50; 95% CI, 0.26–0.94; p = 0.03; BSC vs. surgery: HR, 0.47; 95% CI, 0.25–0.88; p = 0.02) as independent factors for survival after recurrence. Seventeen (12.8%) patients who had localized lymph node recurrence and lung oligometastasis and received multidisciplinary therapy after recurrence survived for >3 years thereafter.

Conclusion

Despite the poor survival of patients with ESCC and early or distant recurrence or recurrence in ≥3 recurrent organs, appropriate multimodal therapies should be tailored for individual patients with recurrent ESCC.

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yoichi Hamai, Jun Hihara, Manabu Emi, Takaoki Furukawa, Yuta Ibuki, Ichiko Yamakita, Tomoaki Kurokawa & Morihito Okada

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  1. Yoichi Hamai
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  2. Jun Hihara
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  3. Manabu Emi
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  4. Takaoki Furukawa
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  5. Yuta Ibuki
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  6. Ichiko Yamakita
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  7. Tomoaki Kurokawa
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  8. Morihito Okada
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Correspondence to Yoichi Hamai.

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The authors have nothing to disclose regarding commercial support or conflicts of interest.

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Hamai, Y., Hihara, J., Emi, M. et al. Treatment Outcomes and Prognostic Factors After Recurrence of Esophageal Squamous Cell carcinoma. World J Surg 42, 2190–2198 (2018). https://doi.org/10.1007/s00268-017-4430-8

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  • DOI: https://doi.org/10.1007/s00268-017-4430-8

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