The forms of postoperative recurrence of esophageal cancer include: local recurrence and systemic distant metastatic recurrence.
The type of esophageal cancer in China is predominantly squamous, accounting for more than 90%, and the form of recurrence is predominantly local recurrence, accounting for more than 50% of all recurrent esophageal cancers.
Local recurrence includes recurrence of the anastomosis, and recurrence of regional lymph nodes such as cervical lymph nodes, mediastinal lymph nodes, and abdominal lymph nodes.
Distant metastases are mainly lung metastases, liver metastases, bone metastases, and brain metastases, while metastases to other sites such as pleura, peritoneum, and adrenal glands are more rare.
What are the symptoms of recurrence of esophageal cancer?
Postoperative local recurrence of esophageal cancer may present with the following symptoms:
- Difficulty in swallowing, retrosternal pain, stuffy discomfort, back pain and belching, etc. Tumor invasion of phrenic nerve may cause eructation;
- Invasion of the recurrent laryngeal nerve can cause hoarseness;
- Compression of trachea and bronchus causes cough and breath-holding;
- Hypopnea, pneumonia and choking may occur in the presence of esophago-bronchial fistula.
Distant metastases after esophageal cancer surgery often cause a series of secondary symptoms, such as swollen lymph nodes in the neck due to lymphatic metastases; breathlessness and pain in the liver area due to hematogenous metastases to the lungs and liver; other symptoms include loss of appetite, emaciation, weakness, and anemia.
If it is confirmed to be a recurrence, can it still be treated?
If esophageal cancer is found to have recurred or metastasized, you should not be depressed, please actively cooperate with your doctor’s treatment and maintain an optimistic state of mind.
After recurrence, whether treated with chemotherapy, radiotherapy or surgery, it can effectively prolong survival, therefore, aggressive treatment after recurrence is very necessary.
Timely and effective treatment can delay further tumor progression and thus control the continued emergence of distant metastases, and can reduce pain, stabilize your disease, improve your quality of life, prolong survival, and even achieve clinical cure.
First, your doctor will help you clarify whether it is a local recurrence or a distant metastasis.
If it is a local recurrence, treatment should be primarily local with systemic therapy, such as “radiation + chemotherapy”, which is synchronized or sequential radiation and chemotherapy.
If the metastasis is distant, the treatment should be systemic therapy to control the metastatic lesion. Individuals with only one distant isolated metastasis may potentially undergo surgical resection if their physical condition allows. Some scholars have reported cases of survival of more than 90 months after postoperative lung metastasectomy for esophageal cancer. In other words, if this is the case, your survival after metastasectomy is still very good.