title: Adjuvant Therapy for a Microscopically Incomplete Resection Margin after an Esophagectomy for Esophageal Squamous Cell Carcinoma.
abstract: Purpose: To investigate the prognosis of esophageal squamous cell carcinoma with a microscopically incomplete (R1) resection margin following an esophagectomy, as well as the impact of adjuvant treatment on survival.Methods: Data obtained from 124 patients with R1-resected ESCC were reviewed. The impact of clinicopathological factors and adjuvant treatment on the overall survival, locoregional recurrence, and distant recurrence were explored.Results:For a median follow-up time of 16.8 months, the median overall survival of 124 patients was 25.6 months. The 1, 3, and 5-year overall survival rates were 75.6%±4.0%, 35.9%±5.1%, and 23.2%±5.0%, respectively. Adjuvant therapy was administered in 78 patients. In the univariate analyses, patients with a pN0 stage (log rank, p=0.028) and adjuvant chemotherapy (log rank, p=0.032) exhibited more favorable overall survival. In the multivariate analyses, the pN stage (HR=2.192, p=0.004) and adjuvant chemotherapy (HR=0.032, p=0.004) were independent prognostic factors for overall survival. Locoregional recurrence was the main failure pattern after R1 resection. The pN stage (HR=2.567, p=0.009) and adjuvant radiotherapy (HR=0.278, p=0.000) were independent prognostic factors for locoregional recurrence.Conclusion:In R1-resected esophageal squamous cell carcinoma, adjuvant radiotherapy reduced locoregional recurrence; however, it did not improve overall survival. Adjuvant chemotherapy demonstrated benefits for overall survival. The pN stage was an independent prognostic factor for locoregional recurrence and overall survival.
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qiu
authors.affiliation: Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, P.R. China.
authors.forename: JiaXiang
authors.initials: J
authors.lastname: Li
authors.affiliation: State Key Laboratory of Oncology in South China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Medical Oncology, un Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: ZhiQiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Medical Oncology, un Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liang
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Medical imaging, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: Peiqiang
authors.initials: P
authors.lastname: Cai
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: ZhaoLin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: MengZhong
authors.initials: M
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: JianHua
authors.initials: J
authors.lastname: Fu
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Oncology in South China,; Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P.R. China,; Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
keywords: Esophageal squamous cell carcinoma; R1 resection; adjuvant chemotherapy; adjuvant radiotherapy; prognosis.