Locally advanced XXXX : What becomes of 5-year survivors?

@entity1 @entity5 @entity358 @entity418 @entity204
OBJECTIVE: To determine the long-term outcomes of @entity1 with locally advanced @entity418 (LAEC) who underwent esophagectomy and survived at least 5  years, and the predictors of disease-free survival (DFS) beyond 5  years. METHODS: This was a retrospective review of a prospective database to identify @entity1 with clinical stage T2N0M0 or higher LAEC. Medical records were reviewed to obtain demographic, clinical, and pathological characteristics, as well as data on recurrence and survival. Multivariable analysis of predictors of DFS beyond 5  years was performed using a Cox regression model. RESULTS: Between 1988 and 2009, 355 of 500 @entity1 underwent esophagectomy for cT2N0M0 or higher disease. Of these 355 @entity1 , 126 were alive and disease-free at the 5-year follow-up, for an actuarial 5-year DFS of 33%. Recurrent @entity418 developed in 8 @entity1 after 5  years. Among the 126 surviving @entity1 , the actuarial overall survival was 94% at 7  years and 80% at 10  years. On multivariable analysis, the sole significant predictor of DFS after the 5-year time point was non-en bloc resection at the original operation (P  =  .006). Pulmonary-related @entity204 accounted for 10 out of 22 noncancer @entity204 . A second @entity5 developed in 23 of the 126 surviving @entity1 . CONCLUSIONS: Prolonged survival can be obtained in one-third of @entity1 with LAEC. An en bloc resection at the original operation is the most significant predictor of prolonged survival. Survivors experience a high rate of second @entity5 and an apparently high rate of @entity204 from @entity358 . Careful follow-up is necessary for these @entity1 , even after the 5-year mark.
