Surgical resection a useful option for recurrent lesions

Surgical resection of recurrent oesophageal squamous cell carcinoma (ESCC) lesions after curative esophagectomy may be beneficial, especially for cases with lower pN stage, lung metastasis, and long recurrence-free interval, according to a study.

Researchers looked at the clinicopathological features of 186 patients (median age 63.3 years) with ESCC who underwent surgical treatment for postoperative recurrent lesions. The tumour was located in the middle thorax (48.4 percent) or the lower thorax (25.3 percent) for most patients; for others, tumour was found in the cervix (4.8 percent) or abdomen (4.8 percent).

In terms of the surgical procedure for the primary lesion, 167 (89.8 percent) patients underwent subtotal esophagectomy and reconstruction. Postoperative complications were documented in 93 (50.0 percent) patients after surgery. Major complications included recurrent nerve paralysis (13.4 percent), respiratory complications (12.9 percent), and anastomotic leakage (10.8 percent).

Lymph node (58.6 percent) was the most common recurrence site, followed by the lung (22.1 percent).

In multivariate Cox proportional hazards model, factors that predicted better overall survival after surgical resection of recurrent lesions were pN stage 0–1 (p=0.0146), lung metastasis (p=0.0274), recurrence-free interval after curative esophagectomy of ≥550 days (p=0.0266), R0 resection (p=0.0009), and absence of severe complications after resection for recurrent lesions (Clavien–Dindo grade <IIIa; p=0.0420).

The researchers highlighted the importance of minimizing surgical risks as much as possible when considering resection for recurrent lesions.