| Citation: |
SHEN Wenbin, GAO Hongmei, ZHU Shuchai, HE Jun, LI Teng, LI Shuguang, LI Youmei, LIU Zhikun, LI Juan, SU Jingwei. Patterns of Failure After Radical Surgery on Patients with StageⅡ/Ⅲ Thoracic Esophageal Squamous Cell Carcinoma[J]. Cancer Research on Prevention and Treatment, 2017, 44(5): 340-346. DOI: 10.3971/j.issn.1000-8578.2017.05.006
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To compare the failure modes of the patients with stage Ⅱ and stage Ⅲ thoracic esophageal squamous cell carcinoma (TESCC) treated with surgery, postoperative radiotherapy (PORT) and postoperative radiotherapy and chemotherapy (POCRT), and to explore the best treatment model for different subgroups.
We retrospectively analyzed 468 patients treated with different treatment with stage Ⅱ and Ⅲ TESCC after radical resection, and analyzed the relation between their clinicopathological characteristics and the failure modes. SPSS19.0 statistical software was used for statistical analysis.
The thoracic-regional recurrence rate was 40.8%, and the distant metastasis rate was 27.4% in the whole group. The 1, 3, 5 years-thoracic-regional recurrence rates were significantly different among the three groups. The distant metastasis rates were not significant among the three groups. Compared with surgery and PORT groups, POCRT group had lower intrathoracic recurrence rate; but, the surgery group had lower distant metastasis rate. Compared with stage Ⅱ patients, stage Ⅲ patients had higher distant metastasis rate. Compared with N0 stage patients, the patients with N1 stage had significantly higher supraclavicular and abdominal lymph node recurrence rate and higher distant metastasis rate. The intrathoracic recurrence rate of N0 stage patients who received postoperative adjuvant therapy were significantly lower than that in patients who received surgery alone, and N1 stage patients seemed to be able to benefit from POCRT. The supraclavicular lymph recurrence rate and intrathoracic recurrence rate of stageⅡpatients who received postoperative adjuvant treatment were significantly lower than those who received surgery alone, but the distant metastasis rates of stage Ⅱ/Ⅲ patients who received postoperative adjuvant therapy were higher than those who received surgery alone.
There are high thoracic-regional recurrence rate and distant metastasis rate in the patients with stageⅡ/Ⅲesophageal squamous cell carcinoma after radical surgery. Compared with PORT, POCRT can significantly reduce the thoracic-region recurrence rate. It is recommended that POCRT could be applied on stageⅡor N1 esophageal cancer patients.
| [1] |
Fok M, Sham Js, Choy D, et al. Postoperative radiotherapy for carcinoma of the esophagus: a prospective, randomized controlled study[J]. Surgery, 1993, 113(2): 138-47. https://www.researchgate.net/publication/14769672_Postoperative_radiotherapy_for_carcinoma_of_the_esophagus_A_prospective_randomized_controlled_study
|
| [2] |
Barreto JC, Posner MC. Transhiatal versus transthoracic esophagectomy for esophageal cancer[J]. World J Gastroenterol, 2010, 16(30): 3804-10. doi: 10.3748/wjg.v16.i30.3804
|
| [3] |
Nakagawa S, Kanda T, Kosugi S, et al. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three field lymphadenectomy[J]. J Am Coil Surg, 2004, 198(2): 205-11. doi: 10.1016/j.jamcollsurg.2003.10.005
|
| [4] |
Baba M, Aikou T, Yoshinaka H, et al. Long-term results of subtotal esophageetomy with three-field lymphadenectomy for carcinoma of the thoracic esophagus[J]. Ann Surg, 1994, 219(3): 310-6. doi: 10.1097/00000658-199403000-00012
|
| [5] |
章文成, 王奇峰, 肖泽芬, 等. Ⅱ和Ⅲ期胸段食管癌术后预防性三维放疗疗效分析[J].中华放射肿瘤学杂志, 2012, 21(2): 136-9. http://cdmd.cnki.com.cn/Article/CDMD-10023-1012447547.htm
Zhang WC, Wang QF, Xiao ZF, et al. A efficacy analysis of intensity-modulated radiotherapy or three-dimensional conformal radiotherapy for resected thoracic esophageal squamous cell carcinoma[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2012, 21(2): 136-9. http://cdmd.cnki.com.cn/Article/CDMD-10023-1012447547.htm
|
| [6] |
肖泽芬, 杨宗贻, 王绿化, 等.食管癌术后淋巴结转移对生存率的影响和放射治疗的意义[J].中华肿瘤杂志, 2004, 26(2): 112-5. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHZL200402016.htm
Xiao ZF, Yang ZY, Wang LH, et al. Influence of the number of lymph node metastasis on survival and significance of postoperative radiotherapy for esophageal carcinoma[J]. Zhonghua Zhong Liu Za Zhi, 2004, 26(2): 112-5. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHZL200402016.htm
|
| [7] |
Rice TW, Adelstein DJ, Chidel MA, et al. Benefit of postoperative aajuvant eherroradiotherapy in locoregionally advanced e80phagea carcinoma[J]. J Thorac Cardiovasc Surg, 2003, 126(5): 1590-6. doi: 10.1016/S0022-5223(03)01025-0
|
| [8] |
Liu Q, Cai XW, Wu B, et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamouscell postoperative radiotherapy[J]. PLoS One, 2014, 9(5): e97225. doi: 10.1371/journal.pone.0097225
|
| [9] |
Hsu PK, Wang BY, Huang CS, et al. Prognostic factors for post-recurrence survival in esophageal squamous cell carcinoma patients with recurrence after resection[J]. J Gastrointest Surg, 2011, 15(4): 558-65. doi: 10.1007/s11605-011-1458-1
|
| [10] |
郭旭峰, 茅腾, 吉春宇, 等.病理N1期胸段食管癌根治术后复发转移危险因素分析[J].中华胃肠外科杂志, 2013, 16(9): 831-4. http://cdmd.cnki.com.cn/Article/CDMD-10089-1015327655.htm
Guo XF, Mao T, Ji CY, et al. Risk factors of recurrence and metastasis in pN1 stage squmous cell carcinoma of the thoracic esophagus after radical esophagectomy with lymphadenectomy[J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2013, 16(9): 831-4. http://cdmd.cnki.com.cn/Article/CDMD-10089-1015327655.htm
|
| [11] |
杨琼, 王玉祥, 何明, 等.影响Ⅲ期食管癌术后患者预后的因素[J].中华肿瘤杂志, 2016, 38(7): 530-7. http://cpfd.cnki.com.cn/Article/CPFDTOTAL-ZGKA201508001152.htm
Yang Q, Wang YX, He M, et al. Factors affecting on long-time survival in patients with stage Ⅲ thoracic esophageal carcinoma after esophagectomy[J]. Zhonghua Zhong Liu Za Zhi, 2016, 38(7): 530-7. http://cpfd.cnki.com.cn/Article/CPFDTOTAL-ZGKA201508001152.htm
|
| [12] |
Zheng B, Zheng W, Zhu Y, et al. Role of adjuvant chemora-diotherapy in treatment of resectable esophageal carcinoma: a meta-analysis[J]. Chin Med J, 2013, 126(6): 1178-82. http://lib.cqvip.com/qk/85656X/201306/45154591.html
|
| [13] |
王玉祥, 杨琼, 何明, 等. Ⅲ期胸段食管鳞癌根治术后的复发规律[J].中华肿瘤杂志, 2017, 39(1): 48-55. http://cdmd.cnki.com.cn/Article/CDMD-10089-1016147927.htm
Wang YX, Yang Q, He M, et al. Patterns of recurrence in patients with stage Ⅲ thoracic esoph ageal squamous cell carcinoma after radical resection[J]. Zhonghua Zhong Liu Za Zhi, 2017, 39(1): 48-55. http://cdmd.cnki.com.cn/Article/CDMD-10089-1016147927.htm
|
| [14] |
李维贵, 张德洲, 马俊杰, 等.食管癌根治术后放疗临床疗效分析[J].中华放射肿瘤学杂志, 2004, 13(3): 342-3. http://www.cnki.com.cn/Article/CJFDTOTAL-XDXH201701038.htm
Li WG, Zhang DZ, Ma JJ, et al. Clinical analysis of radiotherapy after radical resection of esophageal carcinoma[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2004, 13(3): 342-3. http://www.cnki.com.cn/Article/CJFDTOTAL-XDXH201701038.htm
|
| [15] |
陈俊强, 潘建基, 李建成, 等.淋巴结阳性胸段食管鳞癌术后放化疗的临床研究[J].中华放射肿瘤学杂志, 2011, 20(4): 287-90. http://www.cnki.com.cn/Article/CJFDTOTAL-SYAZ201506032.htm
Chen JQ, Pan JJ, Li JC, et al. Clinical study of postoperative chemoradiotherapy of thoracic esophageal squamous cell carcinoma with positive lymph nodes[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2011, 20(4): 287-90. http://www.cnki.com.cn/Article/CJFDTOTAL-SYAZ201506032.htm
|
| [16] |
Shridhar R, Weber J, Hoffe SE, et al. Adjuvant radiation therapy and lymphadenectomy in esophageal cancer: a SEER database analysis[J]. J Gastrointest Surg, 2013, 17(8): 1339-45. doi: 10.1007/s11605-013-2192-7
|
| [17] |
Bédard EL, Inculet RI, Mahhaner RA, et al. The role of surgery and postoperative chemoradiation therapy in patients with lymph node positive esophageal carcinoma[J]. Cancer, 2001, 91(12): 2423-30. doi: 10.1002/(ISSN)1097-0142
|
| [18] |
林宇, 陈俊强, 李建成, 等.淋巴结阳性胸段食管鳞癌术后放化疗的价值[J].中华肿瘤杂志, 2014, 36(2): 151-4. http://cpfd.cnki.com.cn/Article/CPFDTOTAL-ZJKX201306001017.htm
Lin Y, Chen JQ, Li JC, et al. Value of postoperative radiochemotherapy for thoracic esophageal squamous cell carcinoma with lymph node metastasis[J]. Zhonghua Zhong Liu Za Zhi, 2014, 36(2): 151-4. http://cpfd.cnki.com.cn/Article/CPFDTOTAL-ZJKX201306001017.htm
|
| [19] |
Zieren HU, Müller JM, Jacobi CA, et al. Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus: a prospective randomized study[J]. World J Surg, 1995, 19(3): 444-9. doi: 10.1007/BF00299187
|
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