Esophageal cancer recurrence patterns and implications for surveillance Journal Article
| Authors: | Lou, F.; Sima, C. S.; Adusumilli, P. S.; Bains, M. S.; Sarkaria, I. S.; Rusch, V. W.; Rizk, N. P. |
| Article Title: | Esophageal cancer recurrence patterns and implications for surveillance |
| Abstract: | Introduction: After definitive treatment of esophageal cancer, patients are at high risk for recurrence. Consistent follow-up is important for detection and treatment of recurrence. The optimal surveillance regimen remains undefined. We investigated posttreatment recurrence patterns and methods of detection in survivors of esophageal cancer. Methods: We retrospectively studied a cohort of patients who had undergone surgical resection for esophageal cancer at our institution between 1996 and 2010. Routine computed tomography scan and upper endoscopy were performed for surveillance. Results: In total, 1147 patients with resected esophageal adenocarcinoma or squamous cell carcinoma were included (median follow-up, 46 months). Of these, 723 patients (63%) had received neoadjuvant therapy before surgery. During follow-up, there were 595 deaths (52%) and 435 recurrences (38%) (distant [55%], locoregional [28%], or both [17%]). Half of recurrences were detected as a result of symptoms (n = 217), 45% by routine chest and abdominal computed tomography scan (n = 194), and 1% by surveillance upper endoscopy (n = 6). The recurrence rate decreased from 27 per 100 person-years in posttreatment year 1 to 4 per 100 person-years in year 6. In the first 2 years, the rate of recurrence was higher among patients who had received neoadjuvant therapy (35 per 100 person-years) than among those who had not (14 per 100 person-years) (p < 0.001). Conclusions: The incidence of recurrence is high after esophagectomy for cancer. Surveillance endoscopy has limited value for detection of asymptomatic local recurrence. The yield from follow-up scans diminishes significantly after the sixth year; surveillance scans after that point are likely unnecessary. Copyright © 2013 by the International Association for the Study of Lung Cancer. |
| Keywords: | endoscopy; esophageal cancer; surveillance |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 8 |
| Issue: | 12 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-12-01 |
| Start Page: | 1558 |
| End Page: | 1562 |
| Language: | English |
| DOI: | 10.1097/01.JTO.0000437420.38972.fb |
| PROVIDER: | scopus |
| PUBMED: | 24389438 |
| PMCID: | PMC4066875 |
| DOI/URL: | |
| Notes: | Export Date: 3 February 2014 -- Source: Scopus |
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