Prognostic factor analysis of preoperative radiotherapy for esophageal squamous cell carcinoma

Objective To evaluate the prognostic factors affecting preoperative radiotherapy for esophageal squamous cell carcinoma ( ESCC). Methods Three hundred and eleven patients with ESCC undergone preoperative radiotherapy were retrospectively analyzed. Detailed clinical and histological materials and radiotherapy and surgery records were examined. Univariate and multivariate analyses were used to study the factors affecting prognosis. Results The follow-up rate was 96. 5％ , 123 and 86 patients,respectively were followed up more than 3 and 5 years. The 5-year survival rates of patients without (106 patients) and with (205 patients) tumorremnants in primary locations after radiotherapy were 43. 2％ and 23. 2％ , respectively ( X2 = 11. 53 ,P =0. 001) . The 5-year survival rates of 129 patients with primary tumor remnants but without lymph node metastasis in the T1 +T2 phase, the T3 phase and the T4 phase were 42％ ,30％ and 16％ ,respectively ( X2 = 20. 20 ,P = 0. 000) . The 5-year survival rates of patients without lymph node metastasis (211 patients) and those whose lymph node metastases numbered less than 4( 95 patients)was 38.3％ and 13％ , respectively; the 3-year survival rate of patients whose lymph node metastases numbered greater than 4 was 14％ , and the 5-year survival rate was 0 ( X2 = 42. 13, P= 0. 000). In multivariate analysis, the local region with or without residual cancer, the depth of tumor infiltration, the status of the lymph node, the number of lymph node metastases, and gender were independent prognostic factors ( X2 = 32. 20 ,36. 33 ,18. 24 ,4. 60 ,6. 21 , P = 0. 000 , 0. 000 , 0. 000 , 0. 032 , 0. 013 , respectively) .Conclusions Histological T and N staging following preoperative radiotherapy for ESCC andnumbers of lymph node metastases were critical factors affecting prognosis and could be used for better prediction of its prognosis. Key words: Esophageal neoplasms/radiotherapy; Radiotherapy,preoperative; Esophageal neoplasms/surgery; Prognosis