A preliminary study on the salvage therapy for postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma / 中国医师进修杂志

ABSTRACT

Objective To analyze the treatment effect and influencing factors of salvage therapy for postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma. Methods The clinical data of 174 postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma from January 2008 to December 2011 were retrospectively analyzed. The location of recurrence or metastasis, effect of salvage therapy and influencing factors were specifically focused. Results The 1-, 3-and 5-year overall survival rates after recurrence and metastasis in patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma were 35.0% , 19.3% and 13.3% respectively, and the median survival time was 7 months (95% CI 5.2 to 8.8). Single factor analysis results showed that the gender, age, location of recurrence or metastasis, distant metastasis time and salvage therapy were related to the prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＜0.05 or＜0.01), but the weight loss (≥ 5 kg), lesion extent, lesion location, number of lymph node dissection, postoperative adjuvant treatment method and intrathoracic recurrence time were not related to the prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＞0.05). Multivariate analysis result showed that the distant metastasis time and salvage therapy were the independent risk factors of prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＜0.01). Conclusions Salvage therapy and distant metastasis time are independent risk factors of prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma, and chemoradiotherapy or radiotherapy after postoperative recurrence and metastasis in some extent could prolong the survival time.