TY - JOUR
T1 - Clinical outcomes of surgical resection for recurrent lesion after curative esophagectomy for esophageal squamous cell carcinoma
T2 - a nationwide, large-scale retrospective study
AU - Kudou, Kensuke
AU - Saeki, Hiroshi
AU - Nakashima, Yuichiro
AU - Kimura, Yasue
AU - Oki, Eiji
AU - Mori, Masaki
AU - Shimokawa, Mototsugu
AU - Kakeji, Yoshihiro
AU - Toh, Yasushi
AU - Doki, Yuichiro
AU - Matsubara, Hisahiro
N1 - Funding Information:
We thank the following 36 institutes that cooperated by providing completed questionnaires: Akita University, Oita University, Osaka General Medical Center, Osaka City University, Okayama University, Kagawa Prefectural Central Hospital, Kanazawa University, Kawasaki Medical School General Medical Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Kansai Rosai Hospital, National Hospital Organization Kyushu Cancer Center, Kitakyushu Municipal Medical Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Kindai University, Kumamoto University, Kobe University, Shizuoka Cancer Center Hospital and Research Institute, Shizuoka General Hospital, Jichi Medical University, Shimane University, Tokai University, Tokyo Medical and Dental University, Medical Hospital, Nagaoka Chuo General Hospital, Nagoya City University, Nagoya University, Nara Medical University, Niigata Cancer Center Hospital, Nippon Medical School, Hiroshima City Asa Hospital, Research Institute for Radiation Biology and Medicine, Hiroshima University, National Defense Medical College, Mie University, Yamagata University Hospital, Yamaguchi University, University of Yamanashi Hospital, and Dokkyo Medical University Hospital. We would like to thank Editage (www.editage.com ) for English language editing.
Publisher Copyright:
© 2021, The Author(s).
PY - 2022/1
Y1 - 2022/1
N2 - Background: Several studies have reported the efficacy of resection for recurrent lesions. However, they involved a limited number of subjects. This study aimed to identify a subset of patients who benefit from surgical resection of recurrent lesions after curative esophagectomy for esophageal squamous cell carcinoma. Methods: Clinicopathological features of 186 patients with esophageal squamous cell carcinoma who underwent surgical treatment for postoperative recurrent lesions at 37 accredited institutions of the Japanese Esophageal Society were evaluated. Results: The most common recurrence site was the lymph node (106 cases; 58.6%), followed by the lung (40 cases; 22.1%). Univariate analyses revealed that pN 0–1 at esophagectomy (P = 0.0348), recurrence-free interval of ≥ 550 days (P = 0.0306), R0 resection (P < 0.0001), and absence of severe complications after resection for recurrent lesions (Clavien–Dindo grade < IIIa) (P = 0.0472) were associated with better overall survival after surgical resection. According to multivariate analyses, pN 0–1 (P = 0.0146), lung metastasis (P = 0.0274), recurrence-free interval after curative esophagectomy of ≥ 550 days (P = 0.0266), R0 resection (P = 0.0009), and absence of severe complications after resection for recurrent lesions (Clavien–Dindo grade < IIIa) (P = 0.0420) were independent predictive factors for better overall survival. Conclusions: Surgical resection of recurrent esophageal squamous cell carcinoma lesions is a useful option, especially for cases involving lower pN stage, lung metastasis, long recurrence-free intervals after esophagectomy, and technically resectable lesions. Surgical risks should be minimized as much as possible.
AB - Background: Several studies have reported the efficacy of resection for recurrent lesions. However, they involved a limited number of subjects. This study aimed to identify a subset of patients who benefit from surgical resection of recurrent lesions after curative esophagectomy for esophageal squamous cell carcinoma. Methods: Clinicopathological features of 186 patients with esophageal squamous cell carcinoma who underwent surgical treatment for postoperative recurrent lesions at 37 accredited institutions of the Japanese Esophageal Society were evaluated. Results: The most common recurrence site was the lymph node (106 cases; 58.6%), followed by the lung (40 cases; 22.1%). Univariate analyses revealed that pN 0–1 at esophagectomy (P = 0.0348), recurrence-free interval of ≥ 550 days (P = 0.0306), R0 resection (P < 0.0001), and absence of severe complications after resection for recurrent lesions (Clavien–Dindo grade < IIIa) (P = 0.0472) were associated with better overall survival after surgical resection. According to multivariate analyses, pN 0–1 (P = 0.0146), lung metastasis (P = 0.0274), recurrence-free interval after curative esophagectomy of ≥ 550 days (P = 0.0266), R0 resection (P = 0.0009), and absence of severe complications after resection for recurrent lesions (Clavien–Dindo grade < IIIa) (P = 0.0420) were independent predictive factors for better overall survival. Conclusions: Surgical resection of recurrent esophageal squamous cell carcinoma lesions is a useful option, especially for cases involving lower pN stage, lung metastasis, long recurrence-free intervals after esophagectomy, and technically resectable lesions. Surgical risks should be minimized as much as possible.
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U2 - 10.1007/s10388-021-00878-2
DO - 10.1007/s10388-021-00878-2
M3 - Article
C2 - 34510325
AN - SCOPUS:85114711605
VL - 19
SP - 57
EP - 68
JO - Esophagus
JF - Esophagus
SN - 1612-9059
IS - 1
ER -