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Ann Thorac Surg 2009;87:1697-1702. doi:10.1016/j.athoracsur.2009.03.060
© 2009 The Society of Thoracic Surgeons
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Original Articles: General Thoracic

Adjuvant Radiotherapy After Modified Ivor-Lewis Esophagectomy: Can It Prevent Lymph Node Recurrence of the Mid-Thoracic Esophageal Carcinoma?

Gang Chen, MD, Zhou Wang, MD*, Xiang-yan Liu, MD, Fan-ying Liu, MD

Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China

Accepted for publication March 23, 2009.

* Address correspondence to Dr Wang, Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, 324 Jing Wu Rd, Jinan, 250021, China (Email: wz620226{at}hotmail.com).

Background: Even if complete resection was performed, some patients with esophageal carcinoma still develop tumor recurrence. This study was undertaken to evaluate the effectiveness of adjuvant radiotherapy after modified Ivor-Lewis esophagectomy on preventing lymph node recurrence of the mid-thoracic esophageal carcinoma.

Methods: Three hundred sixty-six patients with mid-thoracic esophageal squamous cell carcinoma who underwent modified Ivor-Lewis esophagectomy between June 1999 and June 2004 were retrospectively reviewed. All patients were followed up within 3 years after surgery to detect lymph node recurrence. The Kaplan-Meier method was used to calculate the recurrence rate, and Cox regression analysis was performed to identify risk factors of lymph node recurrence.

Results: The overall 3-year and 5-year survival rates in all patients were 57.9% and 43.7%, respectively. Lymph node recurrence occurred in 105 patients (28.7%) within 3 years after surgery. The lymph node recurrence rate of patients with postoperative adjuvant radiotherapy was significantly lower than that of those with adjuvant chemotherapy (p = 0.03) and those without adjuvant therapy (p < 0.01). Cox regression analysis showed that T stage, N status, and postoperative adjuvant radiotherapy were independent relevant factors for lymph node recurrence.

Conclusions: Postoperative adjuvant radiotherapy after modified Ivor-Lewis esophagectomy might prevent lymph node recurrence of mid-thoracic esophageal carcinoma.


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Invited Commentary
Jessica Donington
Ann. Thorac. Surg. 2009 87: 1702. [Extract] [Full Text] [PDF]



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J. Donington
Invited Commentary.
Ann. Thorac. Surg., June 1, 2009; 87(6): 1702 - 1702.
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