Multimodal therapy for oligometastases after curative esophagectomy for esophageal cancer.

Abstract

Background: Oligometastases, defined as a limited metastatic disease, have been considered potential therapeutic targets of cancers. This study aimed to clarify the characteristics of oligometastatic recurrence and therapeutic strategy after curative esophagectomy for esophageal cancer.

Methods: Clinical details, such as recurrence site, timing and contents of therapies for recurrence, and prognosis, were examined in 138 patients who experienced recurrence among 366 who underwent curative esophagectomy for esophageal cancer. Oligometastases were defined as three or fewer metastatic recurrence lesions within a single organ or lymph node (LN) station.

Results: Oligometastases were identified in 36 patients (26%). The most common oligometastatic recurrence site was the LN (21 patients), followed by the lung (14 patients). In addition, the oligometastases group had a significantly better prognosis than the multiple metastasis group (P < 0.0001). Analysis for prognostic factors revealed that surgical resection for oligometastases had a significant prognostic impact on long-term survival after treatment for initial recurrence of esophageal cancer (P = 0.012).

Conclusion: Oligometastases serve as a prognostic factor for recurrent esophageal cancer after curative esophagectomy. The surgical resection of isolated oligometastatic recurrences, particularly pulmonary and cervical node metastases, combined with chemotherapy or radiotherapy, represents a promising treatment strategy with a survival benefit in recurrent esophageal cancer.