Objective: To analyze the characteristics and factors affecting the recurrence in esophageal cancer within the first year after esophagectomy.
Methods: We reviewed retrospectively the clinical and follow-up data of 320 patients who underwent surgical treatment from April 2009 to April 2013 in Sichuan Provincial Cancer Hospital.
Results: 72 cases (72/320, 22.5%) had tumor recurrence within the first year after surgery. The average recurrence time was 6.89±3.53 months and the median recurrence time was 6.02 months. Univariate analysis showed that T stage, N stage, G grade, and pathological stage are related to the recurrence (P<0.05 for all). Logistic regression analysis showed that pathological stage is an independent risk factor for recurrence (P=0.002). There were 46 cases (46/72, 63.9%) of local recurrence and 26 cases (26/72, 36.1%) of distant metastasis. Among the 46 cases of local recurrence, 27 cases (27/46, 58.7%) had upper mediastinal lymph node metastasis. Among the 26 cases of distant metastasis, there were 11 cases (11/26, 42.3%) of pulmonary metastasis. Among the 72 cases of recurrence, the average number of dissected lymph nodes and involved nodes were 29.40±11.41 and 4.37±5.65, respectively, in patients with distant metastasis, and 21.18±10.37 and 1.91±2.14, respectively, in patients with local recurrence. Both the number of dissected and involved lymph nodes were significantly higher in the patients with distant metastasis (P<0.05).
Conclusions: Lymph node metastasis is the most common pattern of recent relapse after esophagectomy, and pathological stage is an independent risk factor for recurrence within the first year after surgery. Standardized lymph node dissection and rational treatment strategy is the key measures to reduce early recurrence of esophageal cancer.