Characteristics of Postoperative Recurrence in Lymph Node-Negative Superficial Esophageal Carcinoma

• Published in: World journal of surgery 2016-07, Vol.40 (7), p.1663-1671
• Main Authors: Ozawa, Yohei, Kamei, Takashi, Nakano, Toru, Taniyama, Yusuke, Miyagi, Shigehito, Ohuchi, Noriaki
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Cardiac Surgery; Endoscopic Submucosal Dissection; Esophageal Carcinoma; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophageal Squamous Cell Carcinoma; Esophagectomy; Female; General Surgery; Humans; Lymph Node Excision; Lymph Node Ratio; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Original Scientific Report; Prognosis; Relapse Patient; Retrospective Studies; Risk Factors; Surgery; Survival Rate; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3454-9

Background This study aimed to evaluate the recurrence rates, timings, locations, and risk factors, and survival in patients with lymph node-negative superficial esophageal squamous cell carcinomas (ESCCs). Methods We investigated 167 patients with pathological T1 thoracic ESCC who underwent curative esophagectomy with lymphadenectomy between 1986 and 2013. They were classified into lymph node-negative and lymph node-positive groups, each of which included 15 relapsed patients. The recurrence rates, timings, locations, and risk factors, and survival were examined retrospectively. Results Significantly better recurrence (12.4 %) and the 5-year overall survival (85.7 %) rates were seen in patients with node-negative superficial ESCC compared with those with node-positive superficial ESCC. Relapsed patients with node-negative superficial ESCC showed a 5-month delay in the time to recurrence compared with relapsed patients with node-positive superficial ESCC, but the recurrence locations were similar. Upper thoracic tumors and the presence of lymph node metastases were independent risk factors for recurrence in superficial ESCC patients, but we did not determine any risk factors in patients who were node negative only. The 5-year overall survival rates did not differ between relapsed node-negative and node-positive patients. Furthermore, the mean times to death and the survival rates from recurrence to death were similar in the node-negative (20.3 months and 9.3 %, respectively) and in the node-positive patients (19.1 months and 13.6 %, respectively) who had relapsed. Conclusions Node-negative and node-positive superficial ESCC patients should be followed up similarly, because when recurrences occur, the prognoses and the times to death are similar in node-negative and node-positive superficial ESCC patients.