Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-Ku, Hiroshima City, Hiroshima, 734-0037, Japan.
Surg Today. 2024 Jan;54(1):53-63. doi: 10.1007/s00595-023-02702-z. Epub 2023 May 25.
Various treatments are used for early postoperative recurrence of esophageal cancer, which has a poor prognosis. We evaluated the differences in outcomes and prognoses of each treatment modality between patients with early and late recurrence.
Early and late recurrence were defined as recurrence within and after six postoperative months, respectively. Of the 351 patients with esophageal squamous cell carcinoma who underwent R0 resection esophagectomy, 98 experienced postoperative recurrence (early recurrence, n = 41; late recurrence, n = 57). We evaluated the characteristics of patients with early and late recurrence and compared their treatment responses and prognoses.
Regarding treatment responses for chemotherapy or immunotherapy, the objective response rate was not significantly different between the early- and late-recurrence groups. For chemoradiotherapy, the objective response rate was significantly lower in the early-recurrence group than in the late-recurrence group. The overall survival was significantly worse in the early-recurrence group than in the late-recurrence group. An analysis by treatment type showed that the early-recurrence group had significantly worse overall survival for chemoradiotherapy, surgery, and radiotherapy than the late-recurrence group.
Patients with early recurrence had particularly poor prognoses with worse post recurrence treatment efficacy than those with late recurrence. The differences in the treatment efficacy and prognosis were particularly pronounced for local therapy.
各种治疗方法均用于治疗食管癌术后早期复发，后者预后较差。我们评估了早期和晚期复发患者之间每种治疗方式的结局和预后的差异。
早期和晚期复发分别定义为术后 6 个月内和术后 6 个月后复发。在 351 例接受 R0 切除食管鳞状细胞癌切除术的患者中，98 例发生术后复发（早期复发，n=41；晚期复发，n=57）。我们评估了早期和晚期复发患者的特征，并比较了他们的治疗反应和预后。
在接受化疗或免疫治疗的患者中，早期和晚期复发组的客观缓解率无显著差异。对于放化疗，早期复发组的客观缓解率明显低于晚期复发组。早期复发组的总生存率明显低于晚期复发组。按治疗类型分析显示，与晚期复发组相比，早期复发组接受放化疗、手术和放疗的总生存率明显更差。
与晚期复发患者相比，早期复发患者的预后尤其较差，且复发后治疗效果较差。局部治疗的疗效和预后差异尤为明显。
