Sanz L, Gonzalez J J, Miyar A, Navarrete F, Martinez E
Department of Surgery B, Hospital Central, University of Oviedo, Spain.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2393-7.
BACKGROUND/AIMS: Surgery is still the main treatment option for esophageal cancer; however, long-term survival has remained poor, even when a curative operation is performed. The present study was undertaken to analyze the pattern and time of recurrence after a curative esophagectomy.
We studied 53 patients who underwent curative esophageal resection for cancer between 1985 and 1994. We examined number and pattern of recurrences, time after surgery, and any factor with contribution to carcinoma recurrence.
During the follow-up period, 34 patients had tumor recurrence. The disease-free interval was 12.7 months (SD = 9.8). Twenty patients (58.9%) developed extrathoracic tumor recurrence and 23 patients (67.6%) intrathoracic. In 3 cases an esophageal stump recurrence was presented. Thirteen patients were considered for palliative treatment after recurrence. The 5-year survival rate was 13%, with median survival time between recurrence and death, 4.1 months. The recurrence of disease was always before 40 months after surgery. Any significant difference related with recurrence was observed between the analyzed factors.
The majority of recurrences are developed before 2 years. Neoplastic recurrence is most common at the mediastinum. Palliative treatments after recurrence do not modify the progression of tumor.
背景/目的：手术仍然是食管癌的主要治疗选择；然而，即使进行了根治性手术，长期生存率仍然很低。本研究旨在分析根治性食管切除术后复发的模式和时间。
我们研究了1985年至1994年间接受根治性食管癌切除术的53例患者。我们检查了复发的数量和模式、术后时间以及任何有助于癌复发的因素。
在随访期间，34例患者出现肿瘤复发。无病间期为12.7个月（标准差=9.8）。20例患者（58.9%）出现胸外肿瘤复发，23例患者（67.6%）出现胸内复发。3例出现食管残端复发。13例患者在复发后接受了姑息治疗。5年生存率为13%，复发至死亡的中位生存时间为4.1个月。疾病复发总是发生在术后40个月之前。在分析的因素之间未观察到与复发相关的任何显著差异。
大多数复发发生在2年之前。肿瘤复发最常见于纵隔。复发后的姑息治疗并不能改变肿瘤的进展。
