title: Adjuvant radiotherapy after modified Ivor-Lewis esophagectomy: can it prevent lymph node recurrence of the mid-thoracic esophageal carcinoma?
abstract: BACKGROUND
  Even if complete resection was performed, some patients with esophageal carcinoma still develop tumor recurrence. This study was undertaken to evaluate the effectiveness of adjuvant radiotherapy after modified Ivor-Lewis esophagectomy on preventing lymph node recurrence of the mid-thoracic esophageal carcinoma.
  
  
  METHODS
  Three hundred sixty-six patients with mid-thoracic esophageal squamous cell carcinoma who underwent modified Ivor-Lewis esophagectomy between June 1999 and June 2004 were retrospectively reviewed. All patients were followed up within 3 years after surgery to detect lymph node recurrence. The Kaplan-Meier method was used to calculate the recurrence rate, and Cox regression analysis was performed to identify risk factors of lymph node recurrence.
  
  
  RESULTS
  The overall 3-year and 5-year survival rates in all patients were 57.9% and 43.7%, respectively. Lymph node recurrence occurred in 105 patients (28.7%) within 3 years after surgery. The lymph node recurrence rate of patients with postoperative adjuvant radiotherapy was significantly lower than that of those with adjuvant chemotherapy (p = 0.03) and those without adjuvant therapy (p < 0.01). Cox regression analysis showed that T stage, N status, and postoperative adjuvant radiotherapy were independent relevant factors for lymph node recurrence.
  
  
  CONCLUSIONS
  Postoperative adjuvant radiotherapy after modified Ivor-Lewis esophagectomy might prevent lymph node recurrence of mid-thoracic esophageal carcinoma.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Zhou
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiang-Yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Fan-Ying
authors.initials: FY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies