J Cancer 2017; 8(2):249-257. doi:10.7150/jca.16409

Research Paper

Adjuvant Therapy for a Microscopically Incomplete Resection Margin after an Esophagectomy for Esophageal Squamous Cell Carcinoma

Bo Qiu1, 2, 3*, JiaXiang Li7*, Bin Wang1*, ZhiQiang Wang1, 2, 4, Ying Liang1, 2, 4, Peiqiang Cai1, 2, 5, ZhaoLin Chen1, 2, 3, MengZhong Liu1, 2, 3, JianHua Fu1, 2, 6, Hong Yang1, 2, 6✉, Hui Liu1, 2, 3✉

1. State Key Laboratory of Oncology in South China,
2. Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,
3. Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China,
4. Departments of Medical Oncology, un Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China,
5. Departments of Medical imaging, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China,
6. Departments of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China,
7. Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, P.R. China.
* Dr. Bo Qiu, Dr. JiaXiang Li and Bin Wang contributed equally to this article.

Abstract

Purpose: To investigate the prognosis of esophageal squamous cell carcinoma with a microscopically incomplete (R1) resection margin following an esophagectomy, as well as the impact of adjuvant treatment on survival.

Methods: Data obtained from 124 patients with R1-resected ESCC were reviewed. The impact of clinicopathological factors and adjuvant treatment on the overall survival, locoregional recurrence, and distant recurrence were explored.

Results: For a median follow-up time of 16.8 months, the median overall survival of 124 patients was 25.6 months. The 1, 3, and 5-year overall survival rates were 75.6%±4.0%, 35.9%±5.1%, and 23.2%±5.0%, respectively. Adjuvant therapy was administered in 78 patients. In the univariate analyses, patients with a pN0 stage (log rank, p=0.028) and adjuvant chemotherapy (log rank, p=0.032) exhibited more favorable overall survival. In the multivariate analyses, the pN stage (HR=2.192, p=0.004) and adjuvant chemotherapy (HR=0.032, p=0.004) were independent prognostic factors for overall survival. Locoregional recurrence was the main failure pattern after R1 resection. The pN stage (HR=2.567, p=0.009) and adjuvant radiotherapy (HR=0.278, p=0.000) were independent prognostic factors for locoregional recurrence.

Conclusion: In R1-resected esophageal squamous cell carcinoma, adjuvant radiotherapy reduced locoregional recurrence; however, it did not improve overall survival. Adjuvant chemotherapy demonstrated benefits for overall survival. The pN stage was an independent prognostic factor for locoregional recurrence and overall survival.

Keywords: Esophageal squamous cell carcinoma, R1 resection, adjuvant chemotherapy, adjuvant radiotherapy, prognosis.

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How to cite this article:
Qiu B, Li J, Wang B, Wang Z, Liang Y, Cai P, Chen Z, Liu M, Fu J, Yang H, Liu H. Adjuvant Therapy for a Microscopically Incomplete Resection Margin after an Esophagectomy for Esophageal Squamous Cell Carcinoma. J Cancer 2017; 8(2):249-257. doi:10.7150/jca.16409. Available from http://www.jcancer.org/v08p0249.htm