Risk factors for tumor recurrence in patients with pT(3)N(0)M(0) thoracic esophageal squamous cell carcinoma after esophagectomy

OBJECTIVE: To analyze the factors contributing to recurrence in patients with pT(3)N(0)M(0) thoracic esophageal squamous cell carcinoma (ESCC). METHODS: Patients with pT(3)N(0)M(0) thoracic ESCC who underwent esophagectomy from January 2008 to December 2012 were included retrospectively. The last date of follow-up was 1 December 2016. Multivariate proportional hazard Cox models were used to identify factors associated with total (i.e., any) recurrence (TR), locoregional recurrence (LR), and distant metastasis (DM). RESULTS: A total of 692 patients were included. The median follow-up was 53 months (range: 3–107). The 3- and 5-year TR, LR, and DM rates were 35.8% and 41.0%, 28.7% and 32.1%, and 16.8% and 21.1%, respectively. The Cox analyses showed that the tumor location, number of dissected lymph nodes, and postoperative therapies were significantly associated with LR. The subgroup analysis showed that postoperative therapies could significantly decrease LR in the mediastinum but not in the neck and upper abdomen regions. CONCLUSIONS: The recurrence rate of pT(3)N(0)M(0) thoracic ESCC patients was high, especially for LR in the mediastinum. Postoperative therapies can significantly reduce the incidence of mediastinal recurrence.