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Many cases of esophageal squamous cell carcinoma (ESCC) involve lymph node and distant metastases after esophagectomy, and most patients relapse within 2 years. Intensity-modulated radiotherapy (IMRT) is an important treatment for these cases of recurrence in ESCC and is widely used in clinical practice. A retrospective study of 137 postoperative patients with locoregional recurrences of ESCC who received IMRT was carried out. Kaplan-Meier survival curves and log-rank tests of univariate analysis was performed to assess whether there was a significant association between demographic and clinical features and death after recurrence. For multivariate analysis, the statistically significant results from the Kaplan-Meier method were subjected to Cox regression analysis. A total of 109 male and 28 female patients were included. There were 21 (15.3%), 58 (42.3%), 36 (26.3%), 3 (2.2%), 17 (12.4%), and 2 (1.5%) recurrences in the anastomotic, supraclavicular, mediastinal, tumor bed, polyregional, and abdominal regions, respectively. Univariate analysis showed that the gross tumor volume (GTV) of radiation (&lt;27 vs. ≥27 cm 3 ) and the number of lymph nodes were significantly associated with survival. The survival rates of patients at 1, 2, 3 and 5 years with GTV&lt;27 cm 3 were 72.7, 51.5, 37.1 and 25.9%, respectively, and with GTV≥27 cm 3 were 63.7, 26.9, 17.9 and 0%, respectively. The significant independent prognostic factor was GTV [&lt;27 vs. ≥27 cm 3 ; hazard ratio (HR), 1.746; 95% confidence interval (CI), 1.112-2.741]. In conclusion, GTV of radiation (&lt;27 vs. ≥27 cm 3 ) is an independent factor in predicting locoregional recurrence after ESCC. Patients with GTV&lt;27 cm 3 are likely to have a better prognosis.

Gross tumor volume is an independent prognostic factor in patients with postoperative locoregional recurrence of esophageal squamous cell carcinoma