title: Patterns and time of recurrence after complete resection of esophageal cancer.
abstract: OBJECTIVE
  The results and outcomes of surgical resection for esophageal carcinoma have improved remarkably in recent years; however, recurrence still frequently develops, even after complete resection. The purpose of this study is to clarify the characteristics of recurrence in this patient population.
  
  
  METHODS
  Among 208 patients, who underwent R0 resection for esophageal carcinoma, recurrence developed in 61. Clinical data were available for 56 of these patients, who were the subjects of this study. We evaluated the time, patterns, and treatment of recurrence in these patients.
  
  
  RESULTS
  Recurrence developed within 1 and 2 years after esophagectomy in 71 and 84% of the patients, respectively, and was classified as loco-regional (54%), hematogenous (36%), or mixed type (10%). The prognosis of patients with loco-regional recurrence tended to be better than that of those with distant metastasis, although the difference was not significant (P = 0.088). Patients with recurrence treated by chemotherapy alone or multimodal therapy, such as radiation or surgery combined with systemic chemotherapy, survived significantly longer than those with untreatable recurrence (P = 0.016).
  
  
  CONCLUSIONS
  These findings reinforce the importance of careful follow-up for both loco-regional and hematogenous recurrence after esophagectomy, particularly during the first 2 years.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Rintaro
authors.initials: R
authors.lastname: Yoshida
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Akinori
authors.initials: A
authors.lastname: Egashira
authors.forename: Ohga
authors.initials: O
authors.lastname: Takefumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome