Guo Xu-feng, Fang Wen-tao, Mao Teng, Gu Zhi-tao, Yang Yu, Chen Wen-hu
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China.
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China. Email:
Zhonghua Wai Ke Za Zhi. 2013 Oct;51(10):908-11.
To analyze the clinical and pathologic influencing factors of early recurrence in patients with histological node-negative (pN0 stage) esophageal squamous cell carcinoma after radical esophagectomy.
A retrospective study on 112 consecutive pN0 stage esophageal squamous cell carcinoma patients who underwent esophagectomy with lymphadenectomy by the same surgical team from January 2004 to December 2010. There were 92 male and 20 female patients, aging from 36 to 80 years with a mean age of 60.3 years. The Cox proportional hazards model was used to determine the independent risk factors for recurrence within 3 years after the operation.
Recurrence was recognized in 45 patients (40.2%) within 3 years after operation. The median time to tumor recurrence was 17.4 months. Locoregional recurrence was found in 38 patients (33.9%), and hematogenous metastasis in 7 patients (6.3%). Recurrence closely correlated with tumor location, grade of differentiation, pT stage and pathologic stage (χ(2) = 6.380 to 18.837, P < 0.05). The Cox multivariate analysis showed that tumor location (RR = 1.092, P = 0.049) and pT3-4a stage (RR = 3.296, P = 0.017) were independent risk factors for postoperative locoregional recurrence.
The most common recurrence pattern of patients with pN0 esophageal squamous cell carcinoma would develop recurrence within 3 years after operation is locoregional recurrence. Upper/middle thoracic location and pT3-4a stage are independent risk factors for locoregional recurrence of pN0 esophageal squamous cell carcinoma after operation.
分析根治性食管切除术后组织学淋巴结阴性（pN0期）食管鳞状细胞癌患者早期复发的临床及病理影响因素。
对2004年1月至2010年12月间由同一手术团队行食管切除术及淋巴结清扫术的112例连续pN0期食管鳞状细胞癌患者进行回顾性研究。患者中男性92例，女性20例，年龄36至80岁，平均年龄60.3岁。采用Cox比例风险模型确定术后3年内复发的独立危险因素。
45例患者（40.2%）在术后3年内复发。肿瘤复发的中位时间为17.4个月。38例患者（33.9%）出现局部区域复发，7例患者（6.3%）出现血行转移。复发与肿瘤位置、分化程度、pT分期及病理分期密切相关（χ(2)=6.380至18.837，P<0.05）。Cox多因素分析显示，肿瘤位置（RR=1.092，P=0.049）和pT3-4a期（RR=3.296，P=0.017）是术后局部区域复发的独立危险因素。
pN0食管鳞状细胞癌患者术后3年内最常见的复发模式是局部区域复发。胸段上/中部位置及pT3-4a期是pN0食管鳞状细胞癌术后局部区域复发的独立危险因素。
