Efficacy and Prognosis of Chemoradiotherapy for 501 Patients With Postoperative Recurrence of Esophageal Cancer

Background: To analyze the efficacy and prognosis of chemoradiotherapy for patients with recurrence of esophageal cancer. Method: A single center study was conducted in 501 patients with recurrent esophageal cancer who received chemotherapy and radiotherapy. Univariate or multivariate analysis was performed to assess the survival, recurrence pattern, prognosis of retreatment and influencing factors. Result: The median time to recurrence of esophageal cancer was 11.6 months (range: 0.3-87.4 months), while the median survival time of chemoradiotherapy after recurrence was 12.1 months. Multivariate analysis identified gender, pN stage, log odds of positive lymph nodes (lodds) value, chemotherapy cycle, recurrence time, and combined distant metastasis as independent prognostic factors (P=0.002, 0.035, 0.000, 0.000, 0.000, 0.001). In this study, 157 patients had combined combined distant metastasis, and the 1-, 3-, and 5-year survival rates of these patients after radiotherapy were 43.3%, 9.1%, and 5.5%, respectively. On the contrary, the 1-, 3-, and 5-year survival rates of patients with local regional recurrence (LRR) only were 53.6, 22.6%, and 16.4%, respectively. Statistically, the differences in the survival rates were significant between the above two groups of patients (B=10.786, P=0.001). Meanwhile, we identified recurrence time, chemotherapy cycle, and prescribed dose as the significant factors affecting the prognosis among 344 patients with postoperative LRR only (a=22.605, 13.957, 10.446; P=0.000, 0.000, 0.005). Conclusion: This study showed that chemoradiotherapy is safe and effective in patients with recurrent esophageal cancer, while male patients with late pN stage, high lodds, chemotherapy of ≤ 2 cycles, recurrence time of ≤ 24 months, or combined distant metastasis had a poor prognosis.