Background
Patients and methods
Patients
Patient selection
Diagnosis of recurrence
Follow-up
Statistical analysis
Results
Patients and treatment regimen
Parameter | Number (n = 127) | Adjuvant therapies | ||||||
---|---|---|---|---|---|---|---|---|
S (n = 32) | S + CT | S + RT | S + CRT | |||||
(n = 23) | p value | (n = 26) | p value | (n = 46) | p value | |||
Sex | 1.00 | 0.95 | 0.78 | |||||
Male | 111 | 27 | 20 | 23 | 41 | |||
Female | 16 | 5 | 3 | 3 | 5 | |||
Age (years) | 0.12 | 0.38 | 0.03 | |||||
< 60 | 59 | 10 | 12 | 11 | 26 | |||
≥ 60 | 68 | 22 | 11 | 15 | 20 | |||
Length (cm) | 0.77 | 0.86 | 0.19 | |||||
< 4 | 64 | 14 | 11 | 12 | 27 | |||
≥ 4 | 63 | 18 | 12 | 14 | 19 | |||
T stage | 0.14 | 0.43 | 0.82 | |||||
T1 | 9 | 4 | 1 | 1 | 3 | |||
T2 | 22 | 4 | 8 | 4 | 6 | |||
T3 | 94 | 23 | 14 | 21 | 36 | |||
T4 | 2 | 1 | 0 | 0 | 1 | |||
Nodal stage | 0.63 | 0.10 | 0.80 | |||||
N0 | 41 | 10 | 4 | 14 | 13 | |||
N1 | 68 | 17 | 16 | 8 | 27 | |||
N2 | 14 | 3 | 2 | 4 | 5 | |||
N3 | 4 | 2 | 1 | 0 | 1 | |||
TNM stage | 0.46 | 0.15 | 0.82 | |||||
IIA | 41 | 10 | 4 | 14 | 13 | |||
IIB | 11 | 4 | 2 | 1 | 4 | |||
IIIA | 18 | 3 | 6 | 4 | 5 | |||
IIIB | 53 | 13 | 10 | 7 | 23 | |||
IVA | 4 | 2 | 1 | 0 | 1 | |||
Differentiation | 0.94 | 0.81 | 0.34 | |||||
Poor | 49 | 10 | 7 | 10 | 22 | |||
Moderate | 71 | 20 | 14 | 15 | 22 | |||
Well | 7 | 2 | 2 | 1 | 2 |
Pattern of recurrence
Distribution | S (n = 32) | S + CT (n = 23) | S + RT (n = 26) | S + CRT (n = 46) | Total (n = 127) |
---|---|---|---|---|---|
Recurrence | 27 (84.4%) | 20 (87.0%) | 15 (57.7%)* | 26 (56.5%)* | 88 (69.3%) |
Lymph node | 22 (68.8%) | 19 (82.6%) | 13 (50.0%) | 19 (41.3%)* | 73 (57.5%) |
Anastomosis | 2 (6.3%) | 2 (8.7%) | 1 (3.8%) | 2 (4.3%) | 7 (5.5%) |
Haematology | 8 (25.0%) | 5 (21.7%) | 7 (26.9%) | 12 (26.1%) | 32 (25.2%) |
Mixed | 5 (15.6%) | 5 (21.7%) # | 5 (19.2%) # | 7 (15.2%) | 22 (17.3%) |
No recurrence | 5 (15.6%) | 3 (13.0%) | 11 (42.3%)* | 20 (43.5%)* | 39 (30.7%) |
Distribution of regional lymph node recurrence
Survival
Risk factors related to regional lymph node recurrence
Characteristic | Neck | Upper mediastinum | Abdomen | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Univariable | Univariable | Multivariable | Univariable | Multivariable | ||||||
HR | 95%CI | HR | 95%CI | exp(B) | 95%CI | HR | 95%CI | exp(B) | 95%CI | |
Age (≥ 60 v < 60) | 0.64 | 0.26–1.55 | 1.02 | 0.47–2.23 | – | – | 0.47 | 0.21–1.06 | – | – |
Sex (male v female) | 2.48 | 0.75–7.98 | 0.56 | 0.15–2.16 | – | – | 2.10 | 0.69–6.43 | – | – |
T stage (T1–2 v T3–4) | 0.45 | 0.18–1.17 | 0.68 | 0.29–1.60 | – | – | 2.92 | 0.94–9.11 | – | – |
N stage (N0 v N1–3) | 2.80 | 0.89–8.82 | 1.42 | 0.61–3.31 | – | – | 2.11 | 0.83–5.36 | – | – |
TNM stage (II v III + IV) | 2.52 | 0.92–6.86 | 1.01 | 0.49–2.33 | – | – |
2.87
|
1.76–7.01
| – | – |
Length (≥ 4 cm v < 4 cm) | 1.10 | 0.44–2.75 | 0.93 | 0.43–2.04 | – | – | 0.84 | 0.38–1.89 | – | – |
Tumour emboli (yes v no) | 0.76 | 0.16–3.68 | 1.60 | 0.49–5.26 | – | – | 1.30 | 0.37–4.55 | – | – |
CT (yes v no) | 1.27 | 0.52–3.12 | 1.20 | 0.56–2.60 | – | – | 1.25 | 0.56–2.77 | – | – |
RT (yes v no) | 0.69 | 0.28–1.68 |
0.32
|
0.15–0.71
|
0.30
|
0.13–0.68
|
0.36
|
0.16–0.83
|
0.37
|
0.16–0.85
|
Positive LN in | ||||||||||
UM (yes v no) | 1.17 | 0.35–3.92 |
3.33
|
1.23–9.06
|
3.72
|
1.30–10.67
| 0.73 | 0.22–2.37 | – | – |
LM (yes v no) |
2.97
|
1.19–7.39
| 1.24 | 0.56–2.71 | – | – | 0.67 | 0.29–1.57 | – | – |
Abdomen (yes v no) | 0.92 | 0.37–2.66 | 1.00 | 0.46–2.16 | – | – |
2.59
|
1.15–5.85
|
2.57
|
1.12–5.92
|