Radical operation and adjuvant chemoradiotherapy improve survival in patients with advanced esophageal cancer. However, more than half of these patients suffer recurrence.
In this study, researchers from Japan assessed treatment responses and prognostic factors in patients with recurrent esophageal cancer.
The team analyzed specimens from 258 patients undergoing radical esophagectomy with extended lymphadenectomy for esophageal squamous cell carcinoma, between 1990 and 1999.
The researchers determined the depth of tumor invasion, and the extent and location of lymph node metastases.
In addition, postoperative recurrence was identified from positive findings on successive 3-month examinations of tumor markers, 6-month examinations of ultrasonography, and annual computed tomography.
The team found that of the 258 patients, 95 had recurrence by the end of 2000. Of those 95 patients, 76 received nonsurgical treatment, 7 received operative intervention, and 12 received no treatment.
Researchers analyzed clinicopathologic features of recurrent tumors in order to determine prognostic values.
| Of the 258 patients, 95 had recurrence by the end of 2000.|
Additionally, serum anti-p53 antibodies (S-p53-Abs), serum C-reactive protein concentration (S-CRP), and albumin concentration were also analyzed.
The team determined that the main recurrences were nodal (n = 45) and organ (n = 35).
They also found that of the nonsurgical treatment group, 47 patients received chemoradiotherapy, 17 chemotherapy, and 12 radiotherapy. An overall clinical response was observed in 34% of these patients.
The researchers determined that treatment response was significantly associated with type of recurrence, history of perioperative adjuvant therapy, time of recurrence, number of recurrent tumors, albumin concentration, S-CRP, and S-p53-Abs.
Furthermore, multivariate analysis suggested that S-p53-Abs and S-CRP were independent prognostic factors.
Dr Hideaki Shimada’s team concluded, “The status of S-p53-Abs and S-CRP may predict response and outcome of patients with recurrence of esophageal cancer after radical operation”.