| Objective:The aim of this study is through a retrospective analysis of the clinical data and recurrence data of the 145 postoperative patients with esophageal cancer in our hospital to analysis local regional recurrent patterns and value of postoperative radiotherapy local control,and to guide the target sketch. Methods:145 cases post-esophagectomy or radiotherapy after esophagectomy local regional recurrence patients which had been diagnosed by histopathology of First Affiliated Hospital of Nanchang University from 2008 to 2015 been collected to retrospectively analyzed,including 108 cases post-esophagectomy patients without postoperative radiotherapy and 37 cases with radiothapy. Statistical analysis local regional recurrent type and site and the recurrent lymph node metastasis rate in each site of the patients without postoperative radiotherapy by SPSS20.0 software, then contrast the difference of recurrence patterns with the patients with radiotherapy. Results:1.In 108 cases post-esophagectomy patients,the most common recurrence pattern as lymph node metastasis,the rate was 89.8%,followed by anastomosis recurrence, the rate was 27.8%,tumor bed recurrence was the most rare,the rate was 13.0%(?2=146.084,P=0.000).In 97 cases lymph node metastasis,the most common site was mediasinal metastasis,the rate was 74.2%,followed by supraclavicular lymph node metastasis,the rate was 33.0%,abdominal lymph node metastasis was the most rare, the rate was 13.4%(?2=77.789,P=0.000).There were no statistical differences in supraclacicular lymph node metastasis(?2=2.516,P=0.284)?mediasinal lymph node metastasis(?2=1.258,P=0.533) and abdominal lymph node metastasis(?2=3.604,P=0.165) comparison by upper thoracic?mid-thoracic and lower thoracic esophageal cancer.There was also no statistical differences in contrast with the left and the right supraclacicular region lymph node metastasis(?2=0.524, P=0.469).In 72 cases mediasinal lymph node metastasis,the most common site was upper mediastinal,the rate was 68.0%,followed by middle mediastinal,the rate was 28.9%,lower mediastinal was the most rare,the rate was 2.1%(?2=96.627,P=0.000).2.The recurrence pattern of the patients with postoperative radiotherapy compared with the patients without radiotherapy,there were no statistical differences in lymph node metastasis(?2=1.933,P=0.164)?anastomosis recurrence(?2=0.167,P=0.683) and tumor bed recurrence(?2=0.117,P=0.732).In lymph node metastasis site comparison,there were also no statistical differences in mediasinal lymph node metastasis(?2=1.339,P=0.247)?supraclacicular lymph node metastasis(?2=0.094,P=0.760) and abdominal lymph node metastasis(?2=0.784, P=0.376).In supraclacicular lymph node metastasis site comparison,there were also no statistical difference in left supraclacicular region(?2=0.095,P=0.758) and right supraclacicular region(?2=0.349,P=0.554).In mediasinal lymph node metastasis site comparison, there were no statistical differences in middle mediastinal(?2=0.014,P=0.905) and lower mediastinal(?2=0.161,P=0.689),but patients with postoperative radiotherapy had a higher upper mediastinal lymph node metastasis date than the patients without radiotherapy,and the difference was statistically significant. Conclusion:1.The most common local region recurrence pattern of post-esophagectomy was lymph node metastasis,follow by anastomosis recurrence,and tumor bed recurrence was the most rare.The common site of lymph node metastasis included 4R?2R region and recurrent laryngeal nerve region lymph node(1L?1R?2L?4L?5 region) in upper mediastinal, subcarinal lymph node(7 region) and supraclacicular region.2.The radiotherapy after esophagectomy could significant reduce the upper mediastinal lymph node metastasis rate.The radiation field should include supraclacicular region ? 7 region and the upper mediasinal region,without lower mediasinal region,and the lower thoracic esophageal cancer should include abdominal lymph node region. |
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