Prognostic impact of the period between surgery and postoperative irradiation in esophageal carcinoma.
One hundred and sixty-two esophageal carcinomas curatively resected and followed by postoperative irradiation were analyzed to investigate whether the delay of postoperative irradiation affected the patients' prognosis. The period of 40 or more days between surgery and postoperative irradiation caused significantly worse survival rates, and this fact was true even if the survival rates were corrected by the other significantly important prognostic factors: age and tumor staging. The incidence of infield recurrence and cancerous death were higher in the patients with the waiting period of 40 or more days. Significant repopulation of residual tumor cells in curatively resected esophageal carcinomas begins 40 days after surgery, therefore, postoperative irradiation should be started within 40 days after a radical resection. The difference of survival rates as related to the waiting period became clear after the follow-up of more than four years. The prognostic difference of subclinical tumors seems to be uncovered several years after treatment.
Yamada
S
S
Department of Radiology, Tohoku University School of Medicine, Sendai.
Takai
Y
Y
Nemoto
K
K
Ogawa
Y
Y
Kakuto
Y
Y
Hoshi
A
A
Sakamoto
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002423:Cause of Death; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors