[Recurrence patterns of esophageal cancer after Ivor-Lewis esophagectomy--a report of 196 cases].

Background & Objective: About one half of the patients with esophageal cancer may recur within 3 years after operation, but the recurrence pattern is still unclear. This study was to investigate the recurrence patterns of esophageal cancer after Ivor-Lewis esophagectomy.

Methods: Clinical data of 196 patients with squamous cell carcinoma of the middle third thoracic esophagus, who underwent Ivor-Lewis esophagectomy with two-field lymph node dissection from Jan. 1997 through Jan. 2001, were reviewed. The risk factors of postoperative recurrence within 3 years were analyzed with Logistic regressive model.

Results: Recurrence was recognized in 96 (48.9%) patients within 3 year after operation. The median time to recurrence was 12.2 months. Of the 96 cases of recurrence, 52 (54.1%) were locoregional, including 41 cases (78.8%) of mediastinal lymph node metastasis, and 8 cases (15.3%) of single cervical lymph node metastasis; 44 (45.8%) were hematogenous, including 10 cases of locoregional-hematogenous recurrence, and mainly located at liver, bone, and lung (39, 88.6%). The locoregional recurrence rate was significantly lower in the patients who received postoperative radiotherapy than in the patients have not received postoperative radiotherapy (23.3% vs. 41.3%, P<0.05). Logistic analysis showed that T3 and N1 tumor were independent risk factors of postoperative tumor recurrence.

Conclusions: About one half of the patients would develop recurrent disease within 3 years after Ivor-Lewis esophagectomy, and most of them were with mediastinal lymph node, liver, bone, or lung metastasis. Postoperative radiotherapy is helpful to control locoregional recurrence.