TREATMENTS AND THEIR OUTCOMES FOR RECURRENCE OF THORACIC ESOPHAGEAL CARCINOMA AFTER CURATIVE RESECTION

Abstract

In this study, clinical outcomes of treatments for recurrence of throacic esophageal carcinoma after curative resection were analyzed. Fifty six out of 120 patients, who received curative resection for squamous cell carcinoma of thoracic esophagus between March 1983 and December 1995, experienced a recurrence. These 56 cases were subjected to the study. The sites of recurrence were cervical lymph noden (8 cases), upper mediastinal region (25 cases), a distant organ (16 cases) and others. One-and 2-year recurrence rates were 54% and 86% respectively. The median disease-free survilal period was 11 monhs and median survival period after recurrence was 6 months. The incidence of cervical lymph node recurrence of patients with postoperative irradiation of the T-fields was significantly lower than those without radiation therapy (p<0.05). Patients with cervical lymph node dissection for cervical recurrence and patients with irradiation for upper mediastinal recurrence had relatively good prognosis. Although patients with distant organ metastasis had poor prognosis, active therapies such as transcatheter arterial chemotherapy for liver metastasis or resection of brain metastasis brought some better prognosis. To improve the prognosis of patients with recurred esophageal cancer after curative surgery, not only early diagnosis of recurrence but also vigorous treatment appropriate for the recurred site it would be mandatory.