Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Surg Today. 2012 Aug;42(8):752-8. doi: 10.1007/s00595-012-0133-9. Epub 2012 Feb 28.
The results and outcomes of surgical resection for esophageal carcinoma have improved remarkably in recent years; however, recurrence still frequently develops, even after complete resection. The purpose of this study is to clarify the characteristics of recurrence in this patient population.
Among 208 patients, who underwent R0 resection for esophageal carcinoma, recurrence developed in 61. Clinical data were available for 56 of these patients, who were the subjects of this study. We evaluated the time, patterns, and treatment of recurrence in these patients.
Recurrence developed within 1 and 2 years after esophagectomy in 71 and 84% of the patients, respectively, and was classified as loco-regional (54%), hematogenous (36%), or mixed type (10%). The prognosis of patients with loco-regional recurrence tended to be better than that of those with distant metastasis, although the difference was not significant (P = 0.088). Patients with recurrence treated by chemotherapy alone or multimodal therapy, such as radiation or surgery combined with systemic chemotherapy, survived significantly longer than those with untreatable recurrence (P = 0.016).
These findings reinforce the importance of careful follow-up for both loco-regional and hematogenous recurrence after esophagectomy, particularly during the first 2 years.
近年来，食管癌手术切除的结果和预后显著改善；然而，即使完全切除后，仍经常复发。本研究旨在阐明该患者人群复发的特征。
在 208 例接受食管癌 R0 切除术的患者中，有 61 例发生复发。本研究的对象是其中 56 例有临床资料的患者。我们评估了这些患者的复发时间、模式和治疗情况。
术后 1 年和 2 年内分别有 71%和 84%的患者复发，复发类型分为局部区域（54%）、血行（36%）或混合类型（10%）。局部区域复发患者的预后倾向于优于远处转移患者，尽管差异无统计学意义（P=0.088）。接受化疗单药或多模态治疗（如放疗或手术联合全身化疗）的复发患者的生存时间明显长于无法治疗的复发患者（P=0.016）。
这些发现强调了食管癌手术后密切随访局部区域和血行复发的重要性，尤其是在术后前 2 年。
