Predicting initial recurrence pattern of esophageal cancer after neoadjuvant chemotherapy

Background/Aims: No report has reviewed which clinicopathological factors i ncluding 3-field dissection and the response to neoadjuvant chemotherapy ca n predict the recurrence pattern of an esophageal carcinoma. The aim of thi s study was to reveal clinicopathological predictors for the initial recurr ence pattern of a thoracic esophageal carcinoma. Methodology: Sixteen parameters derived from 98 patients who underwent a cu rative esophagectomy with neoadjuvant chemotherapy for a squamous cell carc inoma of the thoracic esophagus were examined using univariate and multivar iate logistic regression analyses. Results: Thirty-seven (37.8%) of the 98 patients had recurrences (hematogen ous; 16, lymphatic; 13, others; 8). Univariate analyses revealed that the c ompletion of S-field dissection was the only factor for suppressing the lym phatic recurrence (P=0.009; odds ratio: 0.2). Multivariate analyses showed that the number of positive nodes was a significant predictor for recurrenc e including all modalities (P=0.02; odds ratio: 1.2) and both the number of positive nodes (P=0.04; odds ratio: 1.1) and the poor response to neoadjuv ant chemotherapy (P=0.02; odds ratio: 6.9) were significant predictors for the hematogenous recurrence. Conclusions: The number of positive nodes and the response to neoadjuvant c hemotherapy could predict the hematogenous recurrence of esophageal carcino ma.