6533b85dfe1ef96bd12bdfa4

RESEARCH PRODUCT

Recurrence of esophageal cancer after R0 surgery: risk factors and evolution

Fernando López-mozosJavier López-sebastiánJoaquín Ortega-serranoRoberto Martí-obiol

subject

Malemedicine.medical_specialtyEsophageal NeoplasmsEsophageal cancerRecurrenciaCurative esophagectomyPrognostic factorsRecurrenceRisk FactorsAdjuvant therapymedicineHumansProspective StudiesStage (cooking)Risk factorlcsh:RC799-869Prospective cohort studyLymph nodeCáncer de esófagobusiness.industryEsofaguectomía curativaGastroenterologyGeneral MedicineMiddle AgedEsophageal cancermedicine.diseaseSurgeryDissectionTreatment Outcomemedicine.anatomical_structureFemalelcsh:Diseases of the digestive system. GastroenterologyLymphNeoplasm Recurrence LocalbusinessFactores pronóstico

description

Introduction despite advances in surgical and adjuvant therapy, recurrence in esophageal cancer submitted to R0 surgery remains high. The aim is to define risk factors and recurrence patterns. Additionally, to show the management carried out and the outcome of patients showing recurrence. Material and methods observational and prospective study that included 61 patients. Neoadjuvancy therapy was indicated on T3, T4 and N+ tumors and every lymph node dissection was performed in two fields. Recurrence is defined at distance, regional or local, when, recurrence is detected after six months. According to clinical features and the recurrences, a palliative, chemotherapeutic or surgical management was indicated. Results there were 54 men and the mean age was 59.7 years. The most frequent stage was the IIA and 17 (27.9%) had positive lymph nodes. Thirty (49.2%) had showed recurrence with a median disease-free interval of 10.5 months. The pTNM, the absence of response to the neoadjuvancy and the presence of compromised lymph nodes were found to be risk factors for recurrence. Only the presence of compromised lymph nodes was significant in the multivariate analysis. After diagnosis of the recurrence, median survival was 7 months and 6 subjects survived beyond 1 year. Conclusions we confirmed the high incidence of recurrence in esophageal cancer, where the presence of compromised lymph nodes is probably the main risk factor. After the diagnosis of a relapse the prognosis would be bad, however there would be a small subsidiary group for treatment where outcomes would be better.

10.4321/s1130-01082013000600002http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082013000600002&lng=en&tlng=en