[Prognostic analysis of esophageal carcinoma patients with stump carcinoma and atypical hyperplasia after esophagectomy].
OBJECTIVE
To analyze the prognostic factors for esophageal carcinoma patients with stump carcinoma and atypical hyperplasia after esophagectomy.


METHODS
From August 2006 to December 2010, 182 esophageal carcinoma patients with stump carcinoma and atypical hyperplasia after esophagectomy treated in our hospital were involved in this study, including 60 cases with grade I-II atypical hyperplasia, 23 cases with grade III atypical hyperplasia, 37 cases with carcinoma in situ, and 62 cases with invasive carcinoma. Prognostic factors for these patients were analyzed.


RESULTS
The 1-, 2-, 3- and 4-year locoregional control rates of these 182 patients were 77.1%, 63.3%, 60.3% and 60.3%, respectively, and the over-all cumulative survival rates were 78.6%, 63.9%, 46.3% and 41.0%, respectively. A total of 56 cases suffered from locoregional recurrence (56/182, 30.8%), including anastomotic recurrence and lymph node metastasis. The number of locoregional recurrence patients of grade I-II of atypical hyperplasia was 13(13/60, 21.7%), grade III atypical hyperplasia and carcinoma in situ 21 (21/60, 35.0%), and invasive carcinoma 22 (22/62, 35.5%). There were no significant differences among the three groups(χ(2) = 3.485, P = 0.175). There were significant differences in locoregional control rate and survival rate among the four treatment groups (P < 0.05). For patients with stump grade I∼II atypical hyperplasia and different stage positive stump margin, the 1-, 2-, 3- and 4-year survival rates of the four treatment groups had significant differences (P < 0.05). As for locoregional control rates, there were no significant differences in the four groups (P > 0.05). Univariate analysis showed that tumor length, depth of invasion, number of metastatic lymph nodes, number of lymph node metastatic fields, pTNM stage, stump pathological grade and treatment modality were main influencing factors for survival rate (P < 0.05);invasion depth, stump pathological grade and treatment modality were important factors for locoregional control. Multivariate Cox regression analysis showed that tumor length, number of metastatic lymph nodes, stump pathological grade and treatment modality were independent influencing factors for survival (all P < 0.05);invasion depth, stump pathological grade and treatment modality were independent influencing factors for locoregional control (all P < 0.05).


CONCLUSIONS
For the patients with stump carcinoma and atypical hyperplasia after esophagectomy, tumor length, number of metastatic lymph nodes, stump pathological grade and treatment modality are independent influencing factors for long-term survival, and invasion depth, stump pathological grade and treatment modality are independent influencing factors for locoregional control.
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Feng
F
Cao
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. Email: wangjun90@aliyun.com.
Jun
J
Wang
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Yun-jie
YJ
Cheng
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Qing
Q
Liu
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Yi
Y
Wang
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Shu-jing
SJ
Long
Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Kai
K
Shang
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011184:Postoperative Period; D015996:Survival Rate