The influence of circumferential resection margin status on Loco-regional recurrence in esophageal squamous cell carcinoma

Authors

  • Hae Jin Park MD,

    1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
    2. Department of Radiation Oncology and CyberKnife Center, Soonchunhyan University Hospital, Seoul, Korea
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  • Hak Jae Kim MD, PhD,

    Corresponding author
    1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
    • Department of Radiation Oncology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Fax: +82-2-765-3327.===

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  • Eui Kyu Chie MD, PhD,

    1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
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  • Chang Hyun Kang MD, PhD,

    1. Department of Thoracic and Cardiovascular Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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  • Young Tae Kim MD, PhD

    1. Department of Thoracic and Cardiovascular Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Abstract

Background

To analyze treatment outcomes and patterns of recurrence, and to examine the impact of adjuvant postoperative radiotherapy (PORT) after esophagectomy in esophageal squamous cell carcinoma (SqCC) regarding the status of circumferential resection margin (CRM).

Patients and Methods

We performed a retrospective review of esophageal cancer patients operated in Seoul National University Hospital between 2003 and 2010. Pathologically proven T3 SqCC patients with written reports mentioning the status of CRM were selected. Fifty-nine out of 71 patients (83.1%) had CRM+. Twenty-eight patients had radiotherapy in CRM+ and CRM−, respectively. The median follow-up period was 17.1 months (range: 5.2–63.1).

Results

Median survival and 2-year overall survival were 13.8 months and 41.9% in CRM+, and 27.3 months and 74.1% in CRM−, respectively. Loco-regional relapse-free survival (LRRFS) rate at 2 years was 33.6% and 74.1% in each groups (P = 0.029). Loco-regional recurrence was the major pattern of failure in CRM+. PORT did not improve LRRFS.

Conclusion

The esophageal SqCC patients with CRM+ after resection showed worse LRRFS. This finding validated the prognostic value of CRM status. Nevertheless, we failed to demonstrate the benefits of adjuvant PORT in CRM+. This might suggest the necessity of neoadjuvant therapy to decrease the CRM+ rate after esophagectomy. J. Surg. Oncol. 2013;107:762–766. © 2012 Wiley Periodicals, Inc.

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