Año 2015 / Volumen 107 / Número 9
Original
Characteristics and pattern of recurrence after curative surgery in oesophageal cancer

539-546

DOI: 10.17235/reed.2015.3748/2015

Elena Rodríguez-Camacho, Salvador Pita-Fernández, Sonia Pértega-Díaz, Beatriz López-Calviño, Teresa Seoane-Pillado,

Resumen
Background: Recurrence in oesophageal cancer continues to remain high after curative surgery. The aim of this study was to determine the presence of recurrence after curative surgery during follow-up, and the associated variables. Methods: A retrospective and prospective follow-up study in patients with an anatomical-pathological diagnosis of oesophageal cancer who underwent curative surgery (n=57) in the health district of XXX during the period 2003-2008. The calculation of recurrence-free survival was made using a competing risks survival analysis. Results: Out of the 57 patients included in the study, 87.7% were men with a mean age of 61.4±10.3 years. The median follow-up period was 18.5 months, during which 28 recurrences were detected (50.9%). Patients with dysphagia on diagnosis of the disease, as well as patients in stages III-IV, have a higher probability of recurrence during the follow-up period. The median disease-free interval was 8.5 months. After one year of follow up 57.1% of the recurrences were diagnosed, and 82.1% after 2 years of follow-up. The median post-recurrence survival rate was 4.7 months. After adjusting for a multivariate regression model, the variable with an independent effect for predicting recurrence is the TNM classification (HR=8.49). Conclusions: The majority of the recurrences will be developed during the 2 years after surgery, with a very poor prognosis. The predictor variable for recurrence is the TMN classification.
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Bibliografía
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1. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No.10 [Internet]. Lyon, France: International Agency for Research on Cancer 2010. [acceso:29.10.2013]. Disponible en: http://globocan.iarc.fr.
2. Stahl M, Mariette C, Haustermans K, et al. Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(Supl. 6):vi51-6. DOI: 10.1093/annonc/mdt342
3. Wolf MC, Stahl M, Krause BJ, et al. Curative treatment of oesophageal carcinoma: Current options and future developments. Radiat Oncol 2011;6:55. DOI: 10.1186/1748-717X-6-55
4. Sugiyama M, Morita M, Yoshida R, et al. Patterns and time of recurrence after complete resection of esophageal cancer. Surg Today 2012;42:752-8. DOI: 10.1007/s00595-012-0133-9
5. Morita M, Kuwano H, Ohno S, et al. Characteristics and sequence of the recurrent patterns after curative esophagectomy for squamous cell carcinoma. Surgery 1994;116:1-7.
6. Bhansali MS, Fujita H, Kakegawa T, et al. Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus. World J Surg 1997;21:275-81. DOI: 10.1007/s002689900228
7. Hulscher JB, van Sandick JW, Tijssen JG, et al. The recurrence pattern of esophageal carcinoma after transhiatal resection. J Am Coll Surg 2000;191:143-8. DOI: 10.1016/S1072-7515(00)00349-5
8. Dresner SM, Griffin SM. Pattern of recurrence following radical oesophagectomy with two-field lymphadenectomy. Br J Surg 2000;87:1426-33. DOI: 10.1046/j.1365-2168.2000.01541.x
9. Mariette C, Balon JM, Piessen G, et al. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer 2003;97:1616-23. DOI: 10.1002/cncr.11228
10. Sanchez-Pernaute A, Perez Aguirre E, Hernando Trancho F, et al. Recurrence pattern of esophageal cancer after esophagectomy with two-field lymphadenectomy. Rev Esp Enferm Dig 2003;95:197-201, 191-6.
11. Nakagawa S, Kanda T, Kosugi S, et al. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg 2004;198:205-11. DOI: 10.1016/j.jamcollsurg.2003.10.005
12. Chen G, Wang Z, Liu XY, et al. Recurrence pattern of squamous cell carcinoma in the middle thoracic esophagus after modified Ivor-Lewis esophagectomy. World J Surg 2007;31:1107-14. DOI: 10.1007/s00268-006-0551-1
13. Smit JK, Pultrum BB, van Dullemen HM, et al. Prognostic factors and patterns of recurrence in esophageal cancer assert arguments for extended two-field transthoracic esophagectomy. Am J Surg 2010;200:446-53. DOI: 10.1016/j.amjsurg.2009.12.006
14. Abate E, DeMeester SR, Zehetner J, et al. Recurrence after esophagectomy for adenocarcinoma: Defining optimal follow-up intervals and testing. J Am Coll Surg 2010;210:428-35. DOI: 10.1016/j.jamcollsurg.2010.01.006
15. Lou F, Sima CS, Adusumilli PS, et al. Esophageal cancer recurrence patterns and implications for surveillance. J Thorac Oncol 2013;8:1558-62. DOI: 10.1097/01.JTO.0000437420.38972.fb
16. Lopez-Sebastian J, Marti-Obiol R, Lopez-Mozos F, et al. Recurrence of esophageal cancer after R0 surgery. Risk factors and evolution. Rev Esp Enferm Dig 2013;105:318-25. DOI: 10.4321/S1130-01082013000600002
17. Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: Esophagus and esophagogastric junction. Ann Surg Oncol 2010;17:1721-4. DOI: 10.1245/s10434-010-1024-1
18. Sobin LH, Compton CC. TNM seventh edition: What's new, what's changed: communication from the International Union Against Cancer and the American Joint Committee on Cancer. Cancer 2010;116:5336-9. DOI: 10.1002/cncr.25537
19. Kalbfleisch J, Prentice R. The Statistical Analysis of Failure Time Data. John Willey and Sons, New York; 1980.
20. Gray RJ. A class of K-sample tests for comparing the cumulative incidence of a competing risk. The Annals of Statistics 1988;16:1141-54 DOI: 10.1214/aos/1176350951
21. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. JASA 1999;94:496-509. DOI: 10.1080/01621459.1999.10474144
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Rodríguez-Camacho E, Pita-Fernández S, Pértega-Díaz S, López-Calviño B, Seoane-Pillado T. Characteristics and pattern of recurrence after curative surgery in oesophageal cancer. 3748/2015


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Ficha Técnica

Recibido: 26/02/2015

Aceptado: 03/05/2015

Prepublicado: 11/06/2015

Publicado: 29/08/2015

Tiempo de revisión del artículo: 64 días

Tiempo de prepublicación: 105 días

Tiempo de edición del artículo: 184 días


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