Prognostic viewing for patients with esophageal carcinoma with oligometastatic recurrence after curative resection

Abstract

Background: In this study, we aimed to precisely define oligometastatic recurrence (OLR) in patients with esophageal carcinoma (EC) treated with radical resection and investigate the role of local therapy plus chemotherapy in these patients. Methods: Eighty-three patients with EC who underwent radical esophagectomy and two- or three-field lymphadenectomy, had newly diagnosed recurrence between January 2010 and May 2019 in our hospital, and met the inclusion criteria of the study were recruited. Overall survival (OS) curves after recurrence were analyzed using the Kaplan–Meier method, and a log-rank test was used to assess the OS differences between groups. Cox proportional hazards regression analysis was performed to identify independent factors. Results: The median follow-up time was 15 months (range: 1–147 months). Patients with EC with≤ 5 safe and curative metastases located in a single organ had favorable overall survival compared to those with metastases located in 2–3 organs with or without regional recurrence and/or regional lymph node metastases. In our study, OLR was defined as the presence of a maximum of five safe and curative metastases in a single organ. Patients with EC in the OLR group treated with chemotherapy combined with local treatment (surgical resection, stereotactic body radiotherapy, conventional radiotherapy, and radiofrequency ablation) had a better three-year OS after recurrence than those who received chemotherapy (CT) alone (25.7% vs. 8.3%). The multivariate Cox regression model identified treatment method, differentiation degree, and pathological lymph node stage as independent factors affecting OS after recurrence. Conclusion: OLR was defined as ≤ 5 safe and curative metastases in a single organ. Patients with EC with OLR after curative resection treated with chemotherapy combined with local treatment (CCLT) had favorable OS compared to those treated with CT alone. CCLT is a promising treatment option for patients withEC and OLR.