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Treatment outcomes of cervical esophageal cancer patients
Authors:Michihiro Kudou  Atsushi Shiozaki  Hitoshi Fujiwara  Hirotaka Konishi  Tomohiro Arita  Toshiyuki Kosuga  Ryo Morimura  Yasutoshi Murayama  Shuhei Komatsu  Yoshiaki Kuriu  Hisashi Ikoma  Masayoshi Nakanishi  Daisuke Ichikawa  Kazuma Okamoto  Eigo Otsuji
Affiliation:1.Division of Digestive Surgery, Department of Surgery,Kyoto Prefectural University of Medicine,Kyoto,Japan
Abstract:

Background

Although systemic therapy for esophageal carcinoma has advanced dramatically over the last several decades, the consensus of treatment for cervical esophageal carcinoma (CESCC) has yet remained controversial.

Patients and methods

We analyzed 56 CESCC patients who underwent various therapies in our hospital between January 2000 and December 2013.

Results

Thirteen cases underwent surgery without neo-adjuvant therapy (NAT), while 20 cases underwent surgery after NAT. Definitive chemo-radiotherapy (dCRT) was administered to 23 cases. Five cases underwent salvage surgery after dCRT. Three-year overall survival rates (3-year-OS) were similar between the NAT and dCRT groups (53.3 vs. 51.5 %). These cases were divided into clinical T2/T3 and T4 cases, and a differential analysis was performed. The 3-year-OS achieved by NAT in T2/T3 cases (90.9 %) tended to be better than that by dCRT (62.5 %). In contrast, the 3-year-OS achieved by NAT in T4 cases (12.5 %) tended to be worse than that by dCRT (34.2 %). The prognosis of CESCC patients undergoing salvage surgery after dCRT was very good, with 3-year-OS of 100 % in T2/T3 cases and 66.6 % in T4 cases. A comparative analysis of postoperative complications was performed between CESCC patients undergoing surgery after neo-adjuvant chemotherapy and chemo-radiotherapy to evaluate the operative risk for CESCC patients after CRT. The rates of postoperative complications were similar between these groups.

Conclusion

We analyzed the treatment outcomes of CESCC patients by dividing them according to the clinical tumor invasion depth. Salvage surgery may be an effective therapy for CESCC patients and needs to be considered.
Keywords:
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