Treatment outcome and prognosis of patients with lymph node recurrence of thoracic esophageal squamous cell carcinoma after curative resection.

BACKGROUND: This study aimed to assess treatment outcome and factors influencing survival after lymph node recurrence of thoracic esophageal squamous cell carcinoma (SCC) after curative resection.

METHODS: A total of 207 patients who underwent curative resection of thoracic esophageal SCC between March 1999 and March 2009 were retrospectively analyzed. Of these, lymph node recurrence was observed in 45 (21.7%) patients. Twenty-nine patients received intensive treatment (radiation therapy, chemoradiotherapy, or lymphadenectomy) directed at recurrent nodes, 9 patients received chemotherapy, and 7 patients received best supportive care (BSC). Treatment outcome and prognostic factors of these patients were investigated.

RESULTS: Patients who received intensive treatment had significantly higher survival rates after recurrence than those who received chemotherapy or BSC (P = 0.0049 and 0.0004, respectively). In univariate analysis of survival after recurrence, the number of recurrent nodes (a single node or multiple nodes), the region of recurrent nodes (limited to a single region or extended to multiple regions), and the presence of simultaneous organ recurrence (present or absent) were prognostic factors (P = 0.0004, 0.0017, and <0.0001, respectively). Multivariate analysis demonstrated that the region of recurrent nodes and simultaneous organ recurrence were independent prognostic factors (P = 0.0396 and 0.0006, respectively).

CONCLUSIONS: Our findings suggest that the region of recurrent nodes (limited to a single region or extended to multiple regions) and simultaneous organ recurrence are factors influencing survival after lymph node recurrence of thoracic esophageal SCC after curative resection.