Salvage esophagectomy after definitive chemotherapy and radiotherapy for advanced esophageal cancer |
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Authors: | Nakamura Tsutomu Hayashi Kazuhiko Ota Masaho Eguchi Reiki Ide Hiroko Takasaki Ken Mitsuhashi Norio |
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Affiliation: | Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan. tsutomu@ige.twmu.ac.jp |
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Abstract: | BACKGROUND: Although local recurrence of advanced esophageal cancer is frequent after definitive chemoradiotherapy (CRT), the clinical benefit of salvage esophagectomy has not been elucidated. METHODS: We reviewed 27 patients with squamous-cell cancer who underwent esophagectomy after definitive CRT (> or = 50 Gy) (salvage group) and 28 patients who underwent planned esophagectomy after neoadjuvant CRT (30 to 45 Gy) (neoadjuvant group). RESULTS: The preoperative albumin level and vital capacity were significantly lower in the salvage group than in the neoadjuvant group. Two patients (7.4%) from the salvage group who underwent extended esophagectomy with three-field lymphadenectomy died of postoperative complications, but no deaths occurred after less-invasive surgery. There was no difference of overall postoperative survival between the salvage and neoadjuvant groups. CONCLUSIONS: The outcome of salvage esophagectomy after definitive CRT was similar to that of planned esophagectomy after neoadjuvant CRT. Less-invasive procedures might be better for salvage esophagectomy because of the high operative risk. |
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Keywords: | Definitive chemoradiotherapy Esophageal cancer Neoadjuvant chemoradiotherapy Salvage esophagectomy Squamous-cell carcinoma |
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