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ORIGINAL ARTICLE
Year : 2020  |  Volume : 40  |  Issue : 2  |  Page : 59-67

Risk factors of tumor relapse in patients with clinical stages 1–3 esophageal squamous cell carcinoma after curative surgery


1 Division of Thoracic Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
2 Department of Neurology, National Yang-Ming University Hospital, I-Lan; Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
3 Department of Medicine, National Defense Medical Center, Taipei, Taiwan
4 Division of Thoracic Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei; National Defense Medical Center, Graduate Institute of Medical Science, Taipei, Taiwan

Correspondence Address:
Ying-Yi Chen
Graduate Institute of Medical Science, Division of Thoracic Surgery, Tri-Service General Hospital, 325, Section 2, Cheng-Kung Road, Taipei 114
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmedsci.jmedsci_82_19

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Background: The aim of this study was to determine the risk factors for disease progression in patients with clinical stages 1–3 squamous cell carcinoma (SCC) of the esophagus after curative surgery. Methods: This is a retrospective study of postoperative risk factors for patients with SCC after esophagectomy. The factors related to disease progression, including stage, clinical tumor response, operation types, number of resected lymph node number, standard uptake value (SUV), tumor differentiation, lymphovascular space invasion, perineural invasion, extracapsular invasion, and tumor regression grade, were analyzed. Results: A total of 73 patients treated between 2011 and 2015 were included in the study. Twenty-six patients developed disease recurrence, including 10 locoregional and 16 distant metastases. Clinical tumor response, procedure types, tumor differentiation, extracapsular invasion, and average standard uptake value (SUVmax) were significantly associated with overall survival. On multivariate analysis, clinical tumor response (P = 0.044), minimally invasive esophagectomy (MIE) (P = 0.006), and tumor differentiation (P = 0.042) remained independent predictors for the disease progression. Conclusions: Clinical tumor response, MIE, tumor differentiation, extracapsular invasion, and average SUVmax of tumor (postconcurrent chemoradiotherapy) were independent predictors for the disease progression. Our findings put forward the postoperative predictors of disease progression in esophageal SCC to identify high-risk patients and deliver proper treatment.


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