Predictive factors for early recurrence in patients with esophageal squamous cell carcinoma after curative esophagectomy.
Predictive factors for early recurrence in patients with esophageal squamous cell carcinoma after curative esophagectomy.
复制标题
食管鳞状细胞癌根治性食管切除术后早期复发的预测因素。
DOI：
10.1007/s10388-011-0308-2
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发表时间：
2012
期刊：
影响因子：
2.4
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Shimizu H;Shiozaki A;Kokuba Y;Otsuji E;et al.
背景即使在根治性切除并结合化疗和放射治疗后，食管癌仍然是一种早期复发预后不良的疾病。本研究对食管癌根治性切除患者早期复发的临床病理预测因素进行回顾性评估。方法对81例原发性食管鳞癌根治性切除术后复发的连续患者进行分析。根据复发时间（手术后180天内或之后）将患者分为两个亚组：早期组和晚期组。结果分别有27例（33.3%）和54例（66.7%）患者被分为早期组和晚期组。早期组患者的肿瘤明显比晚期组更深。两组的初始复发模式没有显着差异，两组中三分之二的患者均发现远处复发。早期组和晚期组患者的1年生存率分别为11%和62%。早期组患者复发后的生存率显着低于晚期组患者（p<0.0001）。多因素logistic回归分析显示，存在3个或以上病理性淋巴结转移是与早期复发相关的独立危险因素。结论食管癌即使在根治性手术后也经常发生早期远处复发。病理淋巴结转移数量（3个及以上）是食管癌根治性切除术后早期复发的独立危险因素。
BackgroundEven after curative resection with combined modality treatment by chemotherapy and radiation, esophageal cancer has remained a disease with poor prognosis upon early recurrence. In this study, the clinicopathological predictive factors for early recurrence in patients with curative resected esophageal cancer were retrospectively evaluated.MethodsEighty-one consecutive patients who had recurrence of primary esophageal squamous cell carcinoma after curative resection were analyzed. The patients were classified into two subgroups by time of recurrence (within 180 days of surgery or later): an early group and a late group.ResultsTwenty-seven (33.3%) and 54 (66.7%) patients were classified into the early and late groups, respectively. Patients in the early group had significantly deeper tumors than those in the late group. The initial recurrence patterns were not significantly different between the two groups, and distant recurrences were found in two-thirds of patients in both groups. The 1-year survival rates of patients in the early and late groups were 11 and 62%, respectively. The survival rate after recurrence of patients in the early group was significantly poorer than that of patients in the late group (p< 0.0001). Multivariate logistic regression analysis revealed that the presence of three or more pathological lymph node metastases was an independent risk factor associated with early recurrence.ConclusionsEarly distant recurrences of esophageal cancer frequently occurred even after curative surgery. The number of pathological lymph node metastases (three or more) was the independent risk factor for early recurrence in patients with esophageal cancer after curative resection.