Prognostic Factors of Salvage Esophagectomy for Residual or Recurrent Esophageal Squamous Cell Carcinoma After Definitive Chemoradiotherapy

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2018 Feb 10

PMID 29423738

Citations 13

Authors

Yuki Kiyozumi

Naoya Yoshida

Takatsugu Ishimoto

Taisuke Yagi

Yuki Koga

Tomoyuki Uchihara

Hiroshi Sawayama

Yukiharu Hiyoshi

Masaaki Iwatsuki

Yoshifumi Baba

Yuji Miyamoto

Masayuki Watanabe

Tomohiko Matsuyama

Natsuo Oya

Hideo Baba

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to confirm prognostic factors for salvage esophagectomy for remnant or recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy.

Study Design: We retrospectively analyzed clinicopathological backgrounds of 50 patients who underwent salvage esophagectomy between April 2005 and January 2016. Salvage esophagectomy comprised 40 three-incision esophagectomies, two transhiatal esophagectomies and eight pharyngolaryngoesophagectomies. Independent prognostic factors for overall survival were assessed using Cox regression analysis of the factors.

Results: Salvage esophagectomy remains a highly invasive surgery and correlated with a higher incidence of all morbidities of Clavien-Dindo classification (CDc) ≥II, severe morbidities of CDc ≥ IIIb, any pulmonary morbidities and chylorrhea, compared with those in patients without preoperative definitive chemoradiotherapy. Cox regression analysis suggested that R0 resection (hazard ratio [HR] 6.39; 95% confidence interval [CI] 2.03-9.68, P = 0.002), absence of severe complications (HR 4.97; 95% CI 1.70-14.81, P = 0.004) and early pStage (0-II) (HR 3.42; 95% CI 1.24-10.12, P = 0.018) were independent prognostic factors for salvage esophagectomy.

Conclusions: Salvage esophagectomy remains correlated with a high incidence of postoperative complications. Avoiding non-curative surgery and reducing the incidence of severe postoperative complications are important if patients are to receive prognostic benefit of this highly invasive surgery.

Citing Articles

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Pai C, Chien L, Huang C, Hsu H, Hsu P Cancers (Basel). 2023; 15(22).

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