Recurrence Patterns of Esophageal Cancer after Ivor-Lewis Esophagectomy——a Report of 196 Cases
CHEN Gang, WANG Zhou, LIU Xiang-Yan, LIU Fan-YingDepartment of Thoracic Surgery,Shandong Provincial Hospital,Shandong University,Jinan, Shandong, 250021,P. R. China
BACKGROUND OBJECTIVE: About one half of the patientswith esophageal cancer may recur within 3 years after operation, but therecurrence pattern is still unclear. This study was to investigate therecurrence patterns of esophageal cancer after Ivor-Lewis esophagectomy.METHODS: Clinical data of 196 patients with squamous cell carcinoma of themiddle third thoracic esophagus , who underwent Ivor-Lewis esophagectomywith two-field lymph node dissection from Jan. 1997 through Jan. 2001,were reviewed. The risk factors of postoperative recurrence within 3 yearswere analyzed with Logistic regressive model. RESULTS : Recurrence wasrecognized in 96 ( 48.9%) patients within 3 year after operation. The mediantime to recurrence was 12.2 months. Of the 96 cases of recurrence, 52( 54.1%) were locoregional, including 41 cases ( 78.8%) of mediastinallymph node metastasis, and 8 cases ( 15.3%) of single cervical lymph nodemetastasis; 44 ( 45.8% ) were hematogenous, including 10 cases oflocoregional-hematogenous recurrence, and mainly located at liver, bone,and lung ( 39, 88.6%) . The locoregional recurrence rate was significantlylower in the patients who received postoperative radiotherapy than in thepatients have not received postoperative radiotherapy ( 23.3% vs. 41.3%, P0.05) . Logistic analysis showed that T3 and N1 tumor were independent riskfactors of postoperative tumor recurrence. CONCLUSIONS : About one halfof the patients would develop recurrent disease within 3 years after Ivor-Lewis esophagectomy, and most of them were with mediastinal lymph node,liver, bone, or lung metastasis. Postoperative radiotherapy is helpful to controllocoregional recurrence.
【CateGory Index】： R735.1