Oligometastatic recurrence as a prognostic factor after curative resection of esophageal squamous cell carcinoma
Oligometastatic recurrence as a prognostic factor after curative resection of esophageal squamous cell carcinoma
复制标题
DOI：
10.1007/s00595-020-02173-6
复制
发表时间：
2020-11-01
期刊：
影响因子：
2.5
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Morinaga, Takeshi;Iwatsuki, Masaaki;Baba, Hideo
目的近年来，代表局限性转移性疾病的寡转移概念引起了人们的广泛兴趣。本研究旨在探讨食管鳞状细胞癌切除术后少转移性复发（OLR）。方法选取2005年4月至2019年12月在我院行食管鳞癌根治性切除术的患者514例，其中复发患者97例。OLR定义为单个器官中复发少于5次。我们分析了食管鳞癌根治性切除术后OLR患者的预后因素，特别是复发模式与预后之间的关系，根据治疗，定义为转移导向治疗（MDT）和化疗与局部治疗联合局部治疗（CLT）。结果97例复发患者中43例（44%）出现OLR。OLR组的预后明显好于非OLR组（P = 0.003）。多因素分析显示，OLR是复发后的预后因素（P = 0.007），而复发后的CLT是OLR组中唯一的预后因素（P = 0.024）。结论本研究结果提示OLR是食管鳞癌切除术后的一个预后因素，CLT是食管鳞癌根治性切除术后OLR患者的一种有前途的治疗方式。
Purpose In recent years, the concept of oligometastasis, which represents limited metastatic disease, has gained much interest. This study focuses on the oligometastatic recurrence (OLR) of esophageal squamous cell carcinoma (ESCC) after esophagectomy. Methods From among 514 patients who underwent curative resection for ESCC at our hospital between April 2005 and December 2019, 97 patients with recurrence were enrolled in this study. OLR was defined as fewer than five recurrences in a single organ. We analyzed the prognostic factors for patients with OLR after curative resection of ESCC, especially the relationship between the recurrence pattern and prognosis according to treatment, defined as metastasis-directed therapy (MDT) and chemotherapy with local therapy as combined local therapy (CLT). Results OLR was identified in 43 (44%) of the 97 patients with recurrence. The OLR group had a significantly better prognosis than the non-OLR group (P = 0.003). Multivariate analysis revealed that OLR was a prognostic factor after recurrence (P = 0.007) and that CLT after recurrence was the only prognostic factor in the OLR group (P = 0.024). Conclusions The findings of this study suggest that OLR is a prognostic factor after resection of ESCC and that CLT is a promising treatment modality for patients with OLR after curative resection of ESCC.