186. RECURRENT DISEASE AFTER ESOPHAGEAL CANCER SURGERY; A SUBSTUDY OF THE DUTCH NATIONWIDE IVORY STUDY

Autor: Sofie Henckens, Marianne Kalff, Daan Voeten, David Heineman, Maarten Hulshof, Hanneke van Laarhoven, Wietse Eshuis, Peter Baas, Renu Bahadoer, Eric Belt, Baukje Brattinga, Linda Claassen, Admira Cosovic, David Crull, Freek Daams, Annette van Dalsen, Jan Willem Dekker, Marc van Det, Manon Drost, Peter van Duijvendijk, Stijn van Esser, Marcia Gaspersz, Burak Görgec, Richard Groenendijk, Henk Hartgrink, Erwin van der Harst, Jan Willem Haveman, Joos Heisterkamp, Richard van Hillegersberg, Wendy Kelder, Feike Kingma, Willem Koemans, Ewout Kouwenhoven, Sjoerd Lagarde, Frederik Lecot, Philip van der Linden, Misha Luyer, Grard Nieuwenhuijzen, Pim Olthof, Donald van der Peet, Jean-Pierre Pierie, Robert Pierik, Victor Plat, Fatih Polat, Camiel Rosman, Jelle Ruurda, Johanna van Sandick, Rene Scheer, Cettela Slootmans, Meindert Sosef, Odin Sosef, Wobbe de Steur, Hein Stockmann, Fanny Stoop, Guusje Vugts, Guy Vijgen, Viola Weeda, Marinus Wiezer, Martijn van Ooijen, Mark van Berge Henegouwen, Suzanne Gisbertz
Rok vydání: 2022
Předmět:
Zdroj: Diseases of the Esophagus. 35
ISSN: 1442-2050
1120-8694
DOI: 10.1093/dote/doac051.186
Popis: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission. This study investigated the predictors, patterns and survival of recurrent disease following esophageal cancer surgery. This nationwide cohort study included patients with resectable distal esophageal and gastroesophageal junction adenocarcinoma and squamous cell carcinoma undergoing curatively intended esophagectomy from January 2007 until December 2016 (follow-up until January 2020). Patients with distant metastases detected during surgery were excluded. Univariable and multivariable logistic regression were used to identify predictors of recurrent disease. Multivariable Cox regression was used to determine the association of recurrence site (locoregional or distant) and treatment intent (none, palliative, curative) with post-recurrence survival. Among 4626 patients, 45.1% developed recurrent disease at a median of 11 months postoperatively, of whom most had distant metastases (59.8%). Disease recurrences were most frequently hepatic (26.2%) or pulmonary (25.1%). Young age (≤65 years), male sex, adenocarcinoma, open surgery, transthoracic esophagectomy, non-radical resection, higher T-stage, and (y)pN+ stage were significantly associated with disease recurrence. Overall, median post-recurrence survival was 4 months (95%CI 3.6–4.4). Median survival after locoregional recurrence was 7 months (95%CI 5.7–8.4) and favorable compared to distant recurrence (HR = 0.74, 95%CI 0.65–0.84). For 127 patients that underwent curatively intended treatment for recurrence, median survival was 20 months (95%CI 16.4–23.7). This study provides important prognostic information assisting in the surveillance and counseling of patients after curatively intended esophageal cancer surgery. Nearly half of included patients developed recurrent disease, and risk of recurrence was higher in patients with, amongst others, higher tumor stage, non-radical resection and tumor positive lymph nodes. Overall, patients with recurrent disease had limited prospects of survival, although median survival after curatively intended treatment reached 20 months.
Databáze: OpenAIRE
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