Anastomotic recurrence of oesophageal squamous cell carcinoma after transthoracic oesophagectomy.
OBJECTIVE
To assess the incidence of anastomotic recurrence of oesophageal carcinoma and its relationship with proximal surgical margin invaded by tumour.


METHODS
Retrospective study.


METHODS
National Cancer Center, Tokyo.


METHODS
463 patients with thoracic oesophageal squamous carcinoma who underwent transthoracic oesophagectomy with a minimal follow-up of three years.


METHODS
Proximal surgical margin, anastomotic recurrence rate, prognosis.


RESULTS
Anastomotic recurrence developed in 12 of the 463 patients (3%), 10 of whom had histologically clear surgical margins. Sixteen patients had histologically invaded surgical margins, 13 of whom developed recurrent disease, 2 (13%) at the anastomosis. These 2 patients died of other diseases after treatment for their recurrent tumours. Two patients with anastomotic recurrence lived for over 5 years without signs of disease after excision of the recurrent tumour. Necropsy of 47 patients with recurrent tumors showed that only one (2%) was at the anastomosis.


CONCLUSIONS
Anastomotic recurrence was not inevitable and was rarely fatal in patients with invaded proximal surgical margins at transthoracic oesophagectomy. However, although infrequent, it did occur, even in patients with a cancer-free surgical margin. Resection may be indicated for patients with anastomotic recurrence and no other signs of metastases.
Kato
H
H
Department of Surgery, National Cancer Center Hospital and Research Institute, Tokyo, Japan.
Tachimori
Y
Y
Watanabe
H
H
Yamaguchi
H
H
Ishikawa
T
T
Nakanishi
Y
Y
Ochiai
A
A
D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D014041:Tokyo / Q000453:epidemiology