Evaluation of the results of postoperative radiotherapy for esophageal cancer

摘要

AbstractNinety patients with previously untreated squamous cell carcinoma of the thoracic esophagus were treated with surgery and postoperative radiation therapy (RT) at the University of Tokyo between January 1982 and December 1992. Total dose was 50 Gy/5 weeks. The overall 5‐year survival rate was 19.7. Sex, age, tumor site, tumor length, depth of tumor invasion, degree of lymph node metastasis, number of lymph node metastases, presence of macroscopic or microscopic residual tumor, and use of chemotherapy were analyzed for prognostic significance for survival by multivariate analysis. Tumor site (P<0.01) and number of lymph node metastases (P<0.01) were significant prognostic factors for survival of patients with esophageal carcinoma who underwent postoperative RT. Depth of tumor invasion (P<0.09) and presence of macroscopic or microscopic residual tumor (P<0.1) were marginally significant. The 2‐year and 5‐year survival rates were 50.0 and 0 in upper thoracic esophageal cancer, 54.5 and 21.3 in middle thoracic esophageal cancer, and 52.1 and 36.1 in lower thoracic esophageal cancer. The 5‐year survival rate was 41.1 in pT1, 50.0 in pT2, 10.5 in pT3, and 0 in pT4. The 5‐year survival rate was 30.6 in those with no lymph nodes involved, 35.8 in those with 1–3 lymph nodes involved, 27.3 in those with 4–7 lymph nodes involved, and 7.1 in those with 8 or more lymph nodes involved. The 2‐year survival rate was 15.0 for patients who had macroscopic residual tumor, 33.3 for patients whose surgical margins were microscopically involved, and 57.7 for patients whose surgical margins were free of tumor. Careful histological examination of the resected specimen will identify patients most likely to benefit from postoperative RT. Data from this non‐randomized series suggest that postoperative RT improves survival in cases with pT2 or pN1. © 19