title: Vascular invasion is not a risk factor in oesophageal cancer recurrence.
abstract: OBJECTIVE
  The outcome of the treatment of oesophageal cancer remains poor despite improved treatment modalities and recurrence remains a major problem despite improved staging and treatment. The aim was to identify the independent risk factors responsible in the recurrence of oesophageal cancer.
  
  
  METHODS
  The patients who had elective oesophagectomy (n = 244) with curative intent were studied. One hundred and eighty four patients had surgery alone, 44 patients had neo-adjuvant chemotherapy and surgery while 16 patients had neo-adjuvant chemotherapy, surgery and adjuvant chemotherapy. We have analyzed patients who had surgery alone (n = 184). Data was collected for demography, type of operation, histology, staging (TNM), vascular invasion (VI), differentiation of tumour, type of chemotherapy and recurrence of tumour.
  
  
  RESULTS
  The median age was 67 years (IQR 60, 71). The T1, T2, T3 distribution was 10%, 24% and 66% respectively. Forty percent had no nodal involvement (N0) and 60% had N1 stage disease. Twenty three percent of patients had vascular invasion. Univariate analysis of histo-pathological factors identified lymph node yield (p = 0.06), curative resection R0 (p = 0.004) and vascular invasion (VI) (P = 0.69) as prognostic indicators of recurrence. Multivariate analysis showed that number of lymph nodes yielded (p = 0.01) and R0 resection remain independent indicators of recurrence of tumour. However, VI (p = 0.2) and age at disease onset (p = 0.8) were not indicators of recurrence in oesophageal cancer patients.
  
  
  CONCLUSIONS
  R0 and lymph node yield may help to predict the recurrence of oesophageal cancer. However the presence of VI may not be a significant risk factor in disease recurrence.
authors.affiliation: Department of Surgery, Royal Derby Hospital, Derby, DE223NE, UK.
authors.forename: N
authors.initials: N
authors.lastname: Waraich
authors.forename: F
authors.initials: F
authors.lastname: Rashid
authors.forename: A
authors.initials: A
authors.lastname: Jan
authors.forename: D
authors.initials: D
authors.lastname: Semararo
authors.forename: R
authors.initials: R
authors.lastname: Deb
authors.forename: P C
authors.initials: PC
authors.lastname: Leeder
authors.forename: S Y
authors.initials: SY
authors.lastname: Iftikhar
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy; D000368:Aged; D001808:Blood Vessels / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors