Scoring system for predicting recurrence after chemoradiotherapy including 5-fluorouracil and platinum for patients with esophageal cancer.

BACKGROUND/AIMS: We have retrospectively evaluated clinical data obtained before therapy to enable reliable prediction of recurrence after chemoradiotherapy (CRT) for esophageal cancer. METHODOLOGY: We analyzed 108 patients who received 5-fluorouracil and platinum combined with 60 Gy radiation. Of the 108 patients, 42 patients with complete response after CRT were selected for this study. The endpoint was recurrence after CRT. Factors significantly related to recurrence were extracted by the multivariate analysis, and a recurrence score was prepared by combining these factors. RESULTS: The median follow-up interval was 18.5 (2-103) months. Recurrent disease was found in 16 (38.1%) patients. In the univariate analysis, recurrence was associated with nutrition status, family history, dysphagia, location, and length of the tumor. In the multivariate analysis, location of the tumor was selected as a significant factor that contributed independently to recurrence after CRT (p < 0.05). The hazard ratios of the five selected factors was approximated and scored. The cumulative probabilities of tumor recurrence were significantly higher in the high score group than in the low score group (47.5% vs. 12.5% at 6 months, p < 0.01). CONCLUSIONS: The recurrence score is suggested to be an appropriate scoring system with which to predict recurrence in patients with esophageal cancer.