Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function

Abstract Background The optimal surveillance period and frequency after curative resection for oesophageal squamous cell carcinoma (OSCC) remain unclear, and current guidelines are mainly based on traditional Kaplan–Meier analyses of cumulative incidence rather than risk analysis. The aim of this st...

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Main Authors: Kyohei Kanematsu, Yozo Kudose, Daichi Utsunomiya, Kentaro Kubo, Yusuke Fujii, Daisuke Kurita, Koshiro Ishiyama, Junya Oguma, Hiroyuki Daiko
Format: Article
Language:English
Published: BMC 2022-12-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-022-10345-5
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author Kyohei Kanematsu
Yozo Kudose
Daichi Utsunomiya
Kentaro Kubo
Yusuke Fujii
Daisuke Kurita
Koshiro Ishiyama
Junya Oguma
Hiroyuki Daiko
author_facet Kyohei Kanematsu
Yozo Kudose
Daichi Utsunomiya
Kentaro Kubo
Yusuke Fujii
Daisuke Kurita
Koshiro Ishiyama
Junya Oguma
Hiroyuki Daiko
author_sort Kyohei Kanematsu
collection DOAJ
description Abstract Background The optimal surveillance period and frequency after curative resection for oesophageal squamous cell carcinoma (OSCC) remain unclear, and current guidelines are mainly based on traditional Kaplan–Meier analyses of cumulative incidence rather than risk analysis. The aim of this study was to determine a suitable follow-up surveillance program following oesophagectomy for OSCC using the hazard function. Methods A total of 1187 patients who underwent curative resection for OSCC between 2000 and 2014 were retrospectively analyzed. The changes in the estimated hazard rates (HRs) of recurrence over time were analyzed according to tumour-node-metastasis stage. Results Four hundred seventy-eight (40.2%) patients experienced recurrence during the follow-up period (median, 116.5 months). The risk of recurrence peaked at 9.2 months after treatment (HR = 0.0219) and then decreased to half the peak value at 24 months post-surgery. The HRs for Stage I and II patients were low (< 0.007) post-treatment. The HR for Stage III patients peaked at 9.9 months (HR = 0.031) and the hazard curve declined to a plateau at 30 months. Furthermore, the HR peaked at 10.8 months (HR = 0.052) in Stage IV patients and then gradually declined from 50 months. Conclusions According to tumour-node-metastasis stage, changes in the HRs of postoperative recurrence in OSCC varied significantly. Intensive surveillance should be undertaken for 3 years in Stage III patients and for 4 years in Stage IV patients, followed by annual screening. For Stage I OSCC patients, a reduction in the surveillance intensity could be taken into consideration.
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spelling doaj.art-abd5a400100a401ab9ae0233026dded42022-12-22T02:48:42ZengBMCBMC Cancer1471-24072022-12-012211910.1186/s12885-022-10345-5Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard FunctionKyohei Kanematsu0Yozo Kudose1Daichi Utsunomiya2Kentaro Kubo3Yusuke Fujii4Daisuke Kurita5Koshiro Ishiyama6Junya Oguma7Hiroyuki Daiko8Department of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalDepartment of Oesophageal Surgery, National Cancer Center HospitalAbstract Background The optimal surveillance period and frequency after curative resection for oesophageal squamous cell carcinoma (OSCC) remain unclear, and current guidelines are mainly based on traditional Kaplan–Meier analyses of cumulative incidence rather than risk analysis. The aim of this study was to determine a suitable follow-up surveillance program following oesophagectomy for OSCC using the hazard function. Methods A total of 1187 patients who underwent curative resection for OSCC between 2000 and 2014 were retrospectively analyzed. The changes in the estimated hazard rates (HRs) of recurrence over time were analyzed according to tumour-node-metastasis stage. Results Four hundred seventy-eight (40.2%) patients experienced recurrence during the follow-up period (median, 116.5 months). The risk of recurrence peaked at 9.2 months after treatment (HR = 0.0219) and then decreased to half the peak value at 24 months post-surgery. The HRs for Stage I and II patients were low (< 0.007) post-treatment. The HR for Stage III patients peaked at 9.9 months (HR = 0.031) and the hazard curve declined to a plateau at 30 months. Furthermore, the HR peaked at 10.8 months (HR = 0.052) in Stage IV patients and then gradually declined from 50 months. Conclusions According to tumour-node-metastasis stage, changes in the HRs of postoperative recurrence in OSCC varied significantly. Intensive surveillance should be undertaken for 3 years in Stage III patients and for 4 years in Stage IV patients, followed by annual screening. For Stage I OSCC patients, a reduction in the surveillance intensity could be taken into consideration.https://doi.org/10.1186/s12885-022-10345-5Oesophageal squamous cell cancerHazard ratesHazard functionRecurrencesurveillance
spellingShingle Kyohei Kanematsu
Yozo Kudose
Daichi Utsunomiya
Kentaro Kubo
Yusuke Fujii
Daisuke Kurita
Koshiro Ishiyama
Junya Oguma
Hiroyuki Daiko
Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
BMC Cancer
Oesophageal squamous cell cancer
Hazard rates
Hazard function
Recurrence
surveillance
title Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
title_full Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
title_fullStr Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
title_full_unstemmed Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
title_short Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function
title_sort surveillance strategy after curative resection for oesophageal squamous cell cancer using the hazard function
topic Oesophageal squamous cell cancer
Hazard rates
Hazard function
Recurrence
surveillance
url https://doi.org/10.1186/s12885-022-10345-5
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