Clinical predictors of early postoperative recurrence after radical esophagectomy for thoracic esophageal cancer.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Esophagus Pub Date : 2023-10-01 Epub Date: 2023-05-24 DOI:10.1007/s10388-023-01014-y

Kazuaki Matsui, Hirofumi Kawakubo, Satoru Matsuda, Yuki Hirata, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Hajime Okita, Yuko Kitagawa

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Abstract

Purpose: Esophagectomy for esophageal cancer has a high incidence rate of early postoperative recurrence and death. This study aimed to identify the clinical and pathological features in early recurrence cases and to confirm the usefulness of prediction using these factors for effective adjuvant therapy and postoperative surveillance.

Methods: One hundred and twenty five patients who developed postoperative recurrence after undergoing radical esophagectomy for thoracic esophageal cancer were classified into two groups as follows: those with early recurrence at ≤ 6 months and those with nonearly recurrence at > 6 months after surgery. After identifying related factors of early recurrence, usefulness of these factors for prediction were examined in all patients with and without recurrence.

Results: The analysis cohort consisted of 43 and 82 patients in the early and nonearly recurrence groups, respectively. In multivariate analysis, factors associated with early recurrence were higher initial levels of tumor markers (squamous cell carcinoma [SCC] ≥ 1.5 ng/ml in tumors, except for adenocarcinoma, and carcinoembryonic antigen [CEA] ≥ 5.0 ng/ml in adenocarcinoma) and higher venous invasion (v), i.e., ≥ 2 (p = 0.040 and p = 0.004, respectively). The usefulness of these two factors for recurrence prediction was confirmed in 378 patients, including 253 patients without recurrence. Patients with at least one of the two factors had significantly higher early recurrence rates than those without any factors in pStages II and III (odds ratio [OR], 6.333; p = 0016 and OR, 4.346; p = 0.008, respectively).

Conclusions: Early recurrence of thoracic esophageal cancer (i.e., during ≤ 6 months after esophagectomy) was associated with higher initial tumor marker levels and pathological findings of v ≥ 2. The combination of these two factors is useful as a simple and critical predictor of early postoperative recurrence.

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癌症食管癌根治术后早期复发的临床预测因素。

目的：食管切除术治疗食管癌症术后早期复发和死亡的发生率较高。本研究旨在确定早期复发病例的临床和病理特征，并确认使用这些因素进行预测对有效辅助治疗和术后监测的有用性。方法：将125例胸段食管癌症根治性食管切除术后复发的患者分为两组： ≤ 6个月和非早期复发的 > 术后6个月。在确定了早期复发的相关因素后，在所有有复发和无复发的患者中检查了这些因素对预测的有用性。结果：分析队列包括43名早期复发组和82名非早期复发组患者。在多变量分析中，与早期复发相关的因素是肿瘤标志物的初始水平较高（鳞状细胞癌[SCC] ≥ 1.5 ng/ml的肿瘤，腺癌和癌胚抗原[CEA]除外 ≥ 腺癌中为5.0ng/ml）和较高的静脉浸润（v）。， ≥ 2（p = 0.040和p = 0.004）。378名患者证实了这两个因素对复发预测的有效性，其中253名患者没有复发。在p阶段II和III中，至少有一种因素的患者的早期复发率明显高于没有任何因素的患者（比值比[OR]，6.333；p = 0016和OR，4.346；p = 分别为0.008）。结论：癌症早期复发（即 ≤ 食管切除术后6个月）与较高的初始肿瘤标志物水平和v ≥ 2.这两个因素的结合作为术后早期复发的简单而关键的预测因素是有用的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.