[Survival analysis of patients with stage II squamous cell carcinoma of the thoracic esophagus after esophagectomy].

BACKGROUND & OBJECTIVE Esophageal cancer is a common malignant tumor in China. At the time of diagnosis, most patients are at locally advanced stage. Up to date, surgical resection is the main treatment of esophageal cancer. This study was to analyze the correlations of clinicopathologic features of stage II thoracic esophageal squamous cell carcinoma (ESCC) to the prognosis. METHODS The clinicopathologic data of 467 patients with stage II thoracic ESCC, treated with surgery from Jan. 1990 to Dec. 1998 in Cancer Center of Sun Yat-sen University, were analyzed. Cumulative survival was analyzed by Kaplan-Meier method and compared by log-rank test. The prognosis was analyzed by Cox regression model. RESULTS The overall 1-, 3-, 5-, and 10-year survival rates were 87.1%, 54.6%, 43.0%, and 32.3%, respectively. The 5-year survival rates of patients at stage II A and stage II B were 51.0% and 19.9%. Of the 467 cases, 81 (17.3%) recurred, and 70 (86.4%) of them recurred within 3 years after operation. Univariate analysis revealed that the factors affecting the prognosis included gender, depth of invasion, lymph node metastasis, pathologic stage, number of lymph node metastatic fields, differentiation, positive surgical margin and tumor recurrence. Multivariate analysis showed that gender, depth of invasion, pathologic stage, number of lymph node metastatic fields, positive surgical margin and tumor recurrence were independent prognostic factors. CONCLUSIONS Gender, depth of invasion, pathologic stage, number of lymph node metastatic fields, positive surgical margin and tumor recurrence are independent prognostic factors of stage II ESCC. Surgery is still the primary treatment for stage II A esophageal cancer; but surgery-dominant treatment combined with other therapies is recommended for stage II B esophageal cancer.