Abstract
Background: Although patients with recurrent diseases have a very poor prognosis, appropriate pre-treatment classification for management of recurrent esophageal cancers has yet to be identified. The patterns of recurrence following radial esophagectomy were retrospectively assessed, and evaluated for possible adaptation as a novel classification of recurrent esophageal cancer. Patients and Methods: One hundred and sixty thoracic esophageal cancer patients (142 men; 18 women), who underwent radical esophagectomy without preoperative treatment, were studied. Results: Recurrence occurred in 59 (36.8%) patients. The relationship between recurrence and clinicopathological features revealed significant associations between recurrence and age at surgery (p<0.05), tumor (p<0.0001), lymph node (p<0.0001) and metastatic status (p<0.01), pathological stage (p<0.0001) and lymph node dissection (p<0.0001). Locoregional recurrence occurred in 13 (22%) patients, distant in 30 (51%) and mixed in 16 (27%). Mixed recurrence occurred the fastest and showed the poorest prognosis. A novel classification for recurrent esophageal cancer was proposed based on the clinical findings. Univariate analysis of the prognostic factors for post-recurrent survival revealed a significant association with distant organ recurrence (p<0.05). Conclusion: Mixed recurrence had a poorer outcome than other recurrences. The proposed classification of clinical findings for recurrent esophageal cancer was shown to be useful; however, further studies with a larger number of recurrent esophageal cancers are required for stage grouping of the proposed classification.
Footnotes
- Received June 2, 2005.
- Accepted June 21, 2005.
- Copyright© 2005 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved