OBJECTIVE: To determine the recurrence patterns and prognosis after resection of esophageal cancer. METHODS: One hundred eighty five patients who developed recurrence after curative resection for squamous-cell carcinoma of the thoracic esophagus were analyzed retrospectively. RESULTS: The median recurrence time was 303 days. Recurrence pattern was catagorized into lymphatic, hematogenous, mixed and anastomotic. The number of patients in each recurrence group was 137, 11, 29, and 8, respectively. The 0.5-, 1-, 2-, 3-, and 4-year overall survival rate was 70.7%, 47.1%, 19.8%, 12.2% and 0%, respectively. Multivariate analysis showed that depth of tumor invasion, lymph node metastasis, operative procedure and different regimens of therapy were significant prognostic factors. CONCLUSION: Lymph node metastasis and the depth of invasion may reflect the biologic behavior of the tumor. Esophagectomy with cervical anastomasis is recommended, additional cervical lymphadenectomy is beneficial in a few patients. Radiotherapy combined with chemotherapy may prolong survival time of patients with recurrence.
OBJECTIVE: To determine the recurrence patterns and prognosis after resection of esophageal cancer. METHODS: One hundred eighty five patients who developed recurrence after curative resection for squamous-cell carcinoma of the thoracic esophagus were analyzed retrospectively. RESULTS: The median recurrence time was 303 days. Recurrence pattern was catagorized into lymphatic, hematogenous, mixed and anastomotic. The number of patients in each recurrence group was 137, 11, 29, and 8, respectively. The 0.5-, 1-, 2-, 3-, and 4-year overall survival rate was 70.7%, 47.1%, 19.8%, 12.2% and 0%, respectively. Multivariate analysis showed that depth of tumor invasion, lymph node metastasis, operative procedure and different regimens of therapy were significant prognostic factors. CONCLUSION: Lymph node metastasis and the depth of invasion may reflect the biologic behavior of the tumor. Esophagectomy with cervical anastomasis is recommended, additional cervical lymphadenectomy is beneficial in a few patients. Radiotherapy combined with chemotherapy may prolong survival time of patients with recurrence.