Prognosis of Stage ⅡB-Ⅲ Thoracic Esophageal Carcinoma Patients Treated with Prophylactic After Radical Esophagectomy

Objective To investigate the effect of prophylactic radiotherapy after radical surgery on the long-term survival of patients with stage ⅡB-Ⅲ thoracic esophageal carcinoma.

Methods We enrolled 336 stage ⅡB (n=65) and Ⅲ(n=271) thoracic esophageal carcinoma patients who underwent radical resection with (S+R, n=116) or without (S, n=220) postoperative prophylactic radiotherapy from 2007 to 2010. The median dose of postoperative radiotherapy was 50 Gy. The Kaplan-Meier method, Log rank test and Cox model were used for survival rate calculation, univariate analysis and multivariate analysis, respectively.

Results The 5-year overall survival (OS) and disease-free survival rates were 29.3% and 25.6%, respectively. The 5-year OS of stage ⅡB patients in S and S+R groups were 30.1% and 48.6%, respectively (χ²=2.279, P=0.131). The 5-year OS of stage Ⅲ patients in S and S+R groups were 24.9% and 32.8%, respectively (χ²=5.865, P=0.015). The 5-year OS of lymph node-positive patients in S and S+R groups were 25.9% and 35.8%, respectively (χ²=7.663, P=0.006). Postoperative prophylactic radiotherapy resulted in significantly decreased intrathoracic and supraclavicular recurrence, and obviously delayed median local recurrence time in S and S+R groups (10.6 vs. 16.3 months; χ²=6.043, P=0.014).

Conclusion Postoperative prophylactic radiotherapy reduces local recurrence and improves the survival of stage Ⅲ or lymph node-positive thoracic esophageal carcinoma patients.