Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Surg Today. 2021 May;51(5):798-806. doi: 10.1007/s00595-020-02173-6. Epub 2020 Nov 1.
In recent years, the concept of oligometastasis, which represents limited metastatic disease, has gained much interest. This study focuses on the oligometastatic recurrence (OLR) of esophageal squamous cell carcinoma (ESCC) after esophagectomy.
From among 514 patients who underwent curative resection for ESCC at our hospital between April 2005 and December 2019, 97 patients with recurrence were enrolled in this study. OLR was defined as fewer than five recurrences in a single organ. We analyzed the prognostic factors for patients with OLR after curative resection of ESCC, especially the relationship between the recurrence pattern and prognosis according to treatment, defined as metastasis-directed therapy (MDT) and chemotherapy with local therapy as combined local therapy (CLT).
OLR was identified in 43 (44%) of the 97 patients with recurrence. The OLR group had a significantly better prognosis than the non-OLR group (P = 0.003). Multivariate analysis revealed that OLR was a prognostic factor after recurrence (P = 0.007) and that CLT after recurrence was the only prognostic factor in the OLR group (P = 0.024).
The findings of this study suggest that OLR is a prognostic factor after resection of ESCC and that CLT is a promising treatment modality for patients with OLR after curative resection of ESCC.
近年来，局限性转移（寡转移）的概念引起了广泛关注，其代表有限的转移病灶。本研究聚焦于食管癌（ESCC）切除术后的寡转移复发（OLR）。
本研究纳入了 2005 年 4 月至 2019 年 12 月期间在我院接受根治性切除术治疗的 514 例 ESCC 患者，其中 97 例患者出现复发。OLR 定义为单一器官中少于 5 处复发。我们分析了 ESCC 根治性切除术后 OLR 患者的预后因素，特别是根据治疗方式（转移导向治疗（MDT）和联合局部治疗的化疗（CLT））分析复发模式与预后的关系。
在 97 例复发患者中，43 例（44%）为 OLR。与非 OLR 组相比，OLR 组的预后显著更好（P=0.003）。多因素分析显示，OLR 是复发后的预后因素（P=0.007），而复发后 CLT 是 OLR 组的唯一预后因素（P=0.024）。
本研究结果表明，OLR 是 ESCC 切除术后的预后因素，CLT 是 ESCC 根治性切除术后 OLR 患者有希望的治疗方式。
