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Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer: a Japanese multi-institutional study of 237 patients

Authors: Hideomi Yamashita, Keiichi Jingu, Yuzuru Niibe, Kuniaki Katsui, Toshihiko Matsumoto, Tomohiro Nishina, Atsuro Terahara

Published in: Radiation Oncology | Issue 1/2017

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Abstract

Background

This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study.

Methods

Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months.

Results

Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37%, local control was 45%, progression-free survival was 24%, and esophageal cancer-specific survival was 42%. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80% (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018).

Conclusions

LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).
Literature
1.
Bhansali MS, Fujita H, Kakegawa T, Yamana H, Ono T, Hikita S, Toh Y, Fujii T, Tou U, Shirozu K. Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus. World J Surg. 1997;21:275–81.CrossRefPubMed
2.
Collard JM, Otte JB, Reynaert MS, Michel LA, Malaise JF, Lengele BG, Hermans BP, Kestens PJ. Extensive lymph node clearance for cancer of the esophagus or cardia: merits and limits in reference to 5-year absolute survival. Hepatogastroenterology. 1995;42:619–27.PubMed
3.
4.
Hsu PK, Wang BY, Huang CS, Wu YC, Hsu WH. Prognostic factors for post-recurrence survival in esophageal squamous cell carcinoma patients with recurrence after resection. J Gastrointest Surg. 2011;15:558–65.CrossRefPubMed
5.
Miyata H, Yamasaki M, Kurokawa Y, Takiguchi S, Nakajima K, Fujiwara Y, Konishi K, Mori M, Doki Y. Survival factors in patients with recurrence after curative resection of esophageal squamous cell carcinomas. Ann Surg Oncol. 2011;18:3353–61.CrossRefPubMed
6.
Nakagawa S, Kanda T, Kosugi S, Ohashi M, Suzuki T. Tatakeyama K Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 2004;198:205–11.CrossRefPubMed
7.
Dresner SM, Griffin SM. Pattern of recurrence following radical oesophagectomy with two-field lymphadenectomy. Br J Surg. 2000;87:1426–33.CrossRefPubMed
8.
Mariette C, Balon JM, Piessen G, Fabre S, Van Seuningen I, Triboulet JP. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer. 2003;97:1616–23.CrossRefPubMed
9.
Nakamura T, Ota M, Narumiya K, Sato T, Ohki T, Yamamoto M, Mitsuhashi N. Multimodal treatment for lymph node recurrence of esophageal carcinoma after curative resection. Ann Surg Oncol. 2008;15:2451–7.CrossRefPubMed
10.
Fakhrian K, Gamisch N, Schuster T, Thamm R, Molls M, Geinitz H. Salvage radiotherapy in patients with recurrent esophageal carcinoma. Strahlenther Onkol. 2012;188:136–42.CrossRefPubMed
11.
Zhang J, Peng F, Li N, Liu Y, Xu Y, Zhou L, Wang J, Zhu J, Huang M, Gong Y. Salvage concurrent radiochemotherapy for postoperative local recurrence of squamous cell esophageal cancer. Radiat Oncol. 2012;7:93.CrossRefPubMedPubMedCentral
12.
Jingu K, Matsushita H, Takeda K, Umezawa R, Takahashi C, Sugawara T, Kubozono M, Abe K, Tanabe T, Shirata Y, et al. Long-term results of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study. BMC Cancer. 2012;12:542.CrossRefPubMedPubMedCentral
13.
14.
15.
Yamashita H, Niibe Y, Yamamoto T, Katsui K, Jingu K, Kanazawa S, Terahara A, Nakagawa K. Lung stereotactic radiotherapy for oligometastases: comparison of oligo-recurrence and sync-oligometastases. Jpn J Clin Oncol. 2016;46:687–91.CrossRefPubMedPubMedCentral
16.
Grünberger B, Raderer M, Schmidinger M, Hejna M. Palliative chemotherapy for recurrent and metastatic esophageal cancer. Anticancer Res. 2007;27:2705–14.PubMed
17.
Choi IK, Seo HY, Sung HJ, Park KH, Kim SJ, Oh SC, Seo JH, Choi CW, Kim BS, Shin SW, et al. Epirubicin, cisplatin, oral UFT, and leucovorin combination chemotherapy in advanced and metastatic esophageal cancer. Med Oncol. 2007;24:33–7.CrossRefPubMed
18.
Komatsu S, Shioaki Y, Ichikawa D, Hamashima T, Kan K, Ueshima Y, Koide K, Lee CJ, Ikeda E, Mutoh F, Kurioka H, Oka T, Yamagishi H. Survival and clinical evaluation of salvage operation for cervical lymph node recurrence in esophageal cancer. Hepatogastroenterology. 2005;52:796–9.PubMed
19.
Depypere L, Lerut T, Moons J, Coosemans W, Decker G, Van Veer H, De Leyn P, Nafteux P. Isolated local recurrence or solitary solid organ metastasis after esophagectomy for cancer is not the end of the road. Dis Esophagus. 2016. doi:10.​1111/​dote.​12508 [Epub ahead of print].PubMed
20.
Kosuga T, Shiozaki A, Fujiwara H, Ichikawa D, Okamoto K, Komatsu S, Otsuji E. Treatment outcome and prognosis of patients with lymph node recurrence of thoracic esophageal squamous cell carcinoma after curative resection. World J Surg. 2011;35:798–804.CrossRefPubMed
21.
Nemoto K, Ariga H, Kakuto Y, Matsushita H, Takeda K, Takahashi C, Takai Y, Yamada S, Hosoi Y. Radiation therapy for loco-regionally recurrent esophageal cancer after surgery. Radiother Oncol. 2001;61:165–8.CrossRefPubMed
22.
Nishimura Y, Koike R, Nakamatsu K, Kanamori S, Suzuki M, Shigeoka H, Shiozaki H. Concurrent chemoradiotherapy with protracted infusion of 5-FU and cisplatin for postoperative recurrent or residual esophageal cancer. Jpn J Clin Oncol. 2003;33:341–5.CrossRefPubMed
23.
Yamashita H, Nakagawa K, Tago M, Nakamura N, Shiraishi K, Ohtomo K. Salvage radiotherapy for postoperative loco-regional recurrence of esophageal cancer. Dis Esophagus. 2005;18:215–20.CrossRefPubMed
24.
Jingu K, Nemoto K, Matsushita H, Takahashi C, Ogawa Y, Sugawara T, Nakata E, Takai Y, Yamada S. Results of radiation therapy combined with nedaplatin (cis-diammineglycoplatinum) and 5-fluorouracil for postoperative locoregional recurrent esophageal cancer. BMC Cancer. 2006;6:50.CrossRefPubMedPubMedCentral
25.
Shioyama Y, Nakamura K, Ohga S, Nomoto S, Sasaki T, Yamaguchi T, Toba T, Yoshitake T, Terashima H, Honda H. Radiation therapy for recurrent esophageal cancer after surgery: clinical results and prognostic factors. Jpn J Clin Oncol. 2007;37:918–23.CrossRefPubMed
26.
Baxi SH, Burmeister B, Harvey JA, Smithers M, Thomas J. Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: retrospective review. J Med Imaging Radiat Oncol. 2008;52:583–7.CrossRefPubMed
27.
Adenis A, Penel N, Horn S, Dominguez S, Vanhuyse M, Mirabel X. Palliative chemotherapy does not improve survival in metastatic esophageal cancer. Oncology. 2010;79:46–54.CrossRefPubMed
28.
Tanaka T, Fujita H, Sueyoshi S, Tanaka Y, Sasahara H, Mori N, Nagano T, Yamana H, Shirouzu K. Second-line combination chemotherapy with docetaxel for cisplatin-pretreated refractory metastatic esophageal cancer: a preliminary report of initial experience. Chemotherapy. 2007;53:449–53.CrossRefPubMed
29.
Minsky BD, Pajak TF, Ginsberg RJ, Pisansky TM, Martenson J, Komaki R, Okawara G, Rosenthal SA, Kelsen DP. INT 0123 (Radiation Therapy Oncology Group 94–05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol. 2002;20:1167–74.CrossRefPubMed
Metadata
Title
Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer: a Japanese multi-institutional study of 237 patients
Authors
Hideomi Yamashita
Keiichi Jingu
Yuzuru Niibe
Kuniaki Katsui
Toshihiko Matsumoto
Tomohiro Nishina
Atsuro Terahara
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0780-5

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