Analysis of early recurrence within 6 months in patients of esophageal squamous cell carcinoma after neoadjuvant therapy followed by surgery
10.3760/cma.j.cn112139-20210205-00069
- VernacularTitle:新辅助治疗后食管鳞状细胞癌患者术后6个月内复发分析
- Author:
Yi HE
1
;
Xiaobin ZHANG
;
Zhichao LIU
;
Yang YANG
;
Bin LI
;
Rong HUA
;
Yifeng SUN
;
Xufeng GUO
;
Jun LIU
;
Hongxuan LI
;
Zhigang LI
Author Information
1. 上海市胸科医院 上海交通大学附属胸科医院胸外科 200030
- Keywords:
Esophageal neoplasms;
Recurrence;
Neoadjuvant therapy
- From:
Chinese Journal of Surgery
2021;59(8):655-659
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To examine the prognosis factors of recurrence of esophageal carcinoma within 6 months after neoadjuvant therapy followd by surgery.Methods:The clinical data of 187 patients with esophageal squamous cell carcinoma who underwent neoadjuvant therapy followed by curative esophagectomy between January 2018 and April 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital were analyzed retrospectively. There were 160 males and 27 females, aging (63.0±7.1) years (range:43 to 76 years). The t test, χ 2 test and rank-sum test were used for univariate analysis of the prognosis factors for recurrence within 6 months postoperative, while the Logistic regression was used for multivariate analysis. Results:There were 30 patients (16.0%) developed recurrence within 6 months after operation, including local recurrence in 1 case, regional recurrence in 11 cases, hematogenous recurrence in 13 cases, and combined recurrence in 5 cases. Univariate analysis suggested that there was a significant difference in T staging of tumor before neoadjuvant therapy (cT), tumor regression grade, circumferential resection margin, pathological T stage (ypT) and pathological N stage (ypN) between the recurrence patients and non-recurrence patients (all P<0.05). Logistic regression analysis suggested that the cT3-4 ( OR=2.701, 95% CI: 1.161 to 6.329, P=0.021) and ypN(+)( OR=1.654, 95% CI: 1.045 to 2.591, P=0.032) were the independent prognosis factors for recurrence within 6 months. Conclusion:The combination of neoadjuvant therapy and surgery is not effective in reducing early postoperative recurrence in patients who have invaded the epineurium before treatment, and still have positive lymph nodes after neoadjuvant therapy.
