Associated factors and prognosis of residual cancer after esophagectomy for squamous cell carcinoma of the esophagus / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To analyze associated factors and the prognosis of patients with residual cancer after esophagectomy for squamous cell carcinoma of the esophagus, and to assess outcomes after salvage treatment.</p><p><b>METHODS</b>Clinical and pathological data of 1074 patients with squamous cell carcinoma of the esophagus who underwent esophagectomy in the Cancer Center of Sun Yat-sen University from 1997 to 2003 were analyzed retrospectively. The relationship between the associated factors (differentiation, location, length of the lesion, surgical route, anastomosis site, T stage, N stage) and the incidence of residual cancer was analyzed, using the chi-squared test and Logistic regression analysis methods. The value and the modality of the salvage treatment were investigated.</p><p><b>RESULTS</b>Forty-four patients had residual cancer (4.3%). Cancers in the upper esophagus were associated with the highest incidence of residual cancer on esophageal stump (6.5%), while the lower esophagus had the highest incidence of residual cancer on gastric stump (0.78%). The Incidence correlated with T and N stage. Logistic regression analysis showed that T and N stage were the risk factors of residual cancer. Three-year survival rate was 22.7% in patients with residual cancer. The mean survival time was 25.2+/-3.3 months. Three-year survival rates of patients with and without salvage treatment were 53.2% and 7.8%, respectively (P=0.027). Three-year survival rate of patients with salvage radiotherapy was 56.0%.</p><p><b>CONCLUSIONS</b>Advanced T and N stage are the risk factors of residual cancer after esophagectomy in the patients with squamous cell carcinoma of the esophagus. Salvage treatment can improve the survival of the patients.</p>