title: Prospective study of adjuvant radiotherapy on preventing lymph node metastasis after Ivor-lewis esophagectomy in esophageal cancer.
abstract: OBJECTIVE
  To investigate whether Ivor-Lewis esophagectomy combined with adjuvant radiotherapy prevents lymphatic metastatic recurrence in esophageal cancer patients.
  
  
  METHODS
  A total of 113 stage IIA esophageal squamous cell carcinoma patients after Ivor-Lewis esophagectomy were accepted mRNA expression of Mucoid 1 (MUC1) gene detection. Positive patients were enrolled onto the adjuvant radiotherapy group (with postoperative adjuvant radiotherapy). Negative patients were enrolled onto the control group (without postoperative adjuvant radiotherapy or chemotherapy). The radiotherapy area consisted of the neck, supraclavicular region, and superior mediastinum (including paraesophageal and paratracheal region). Survival difference was compared by the χ(2) test, and the Kaplan-Meier method was performed to calculate the survival rate and recurrence rate. Logistic regression analysis was performed to determined independent risk factors.
  
  
  RESULTS
  The radiotherapy area lymphatic metastatic recurrence rate in adjuvant radiotherapy group (16.7 %, 5 of 30) was lower than patients without postoperative adjuvant radiotherapy (45.8 %, 38 of 83) (P < 0.05). Only compared to positive patients without postoperative adjuvant radiotherapy (60.0 %, 6 of 10) was the rate (16.7 %, 5 of 30) significantly lower (P < 0.01). Cancer recurrence was recognized in 48.6 % (55 of 113) patients within 3 years after surgery, including 38.1 % (43 of 113) patients with radiotherapy area recurrence. Logistic analysis revealed that T status (P < 0.01) and adjuvant radiotherapy (P < 0.05) were independent risk factors of lymph node metastasis in the first 3 years after surgery.
  
  
  CONCLUSIONS
  In MUC1 mRNA-positive esophageal squamous cell carcinoma patients, adjuvant radiotherapy could significantly reduce the lymph node metastasis rate in the radiotherapy area after Ivor-Lewis esophagectomy. Compared with traditional therapeutic methods, Ivor-Lewis esophagectomy combined with adjuvant radiotherapy can achieve similar curative effects in MUC1 mRNA-positive patients.
authors: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong, China.
authors: Huaxia
authors: H
authors: Chen
authors: Zhou
authors: Z
authors: Wang
authors: Zhe
authors: Z
authors: Yang
authors: Bin
authors: B
authors: Shang
authors: Xiangyan
authors: X
authors: Liu
authors: Gang
authors: G
authors: Chen
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000556:secondary* / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D016629:Esophagectomy / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000235:genetics; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D012333:RNA, Messenger / Q000378:metabolism; D018714:Radiotherapy, Adjuvant
chemical_list: C060192:MUC1 protein, human; D018396:Mucin-1; D012333:RNA, Messenger