Prognostic Factors of Salvage Esophagectomy for Residual or Recurrent Esophageal Squamous Cell Carcinoma After Definitive Chemoradiotherapy
Yuki Kiyozumi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorNaoya Yoshida
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTakatsugu Ishimoto
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTaisuke Yagi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYuki Koga
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTomoyuki Uchihara
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorHiroshi Sawayama
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYukiharu Hiyoshi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorMasaaki Iwatsuki
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYoshifumi Baba
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYuji Miyamoto
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorMasayuki Watanabe
Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, 135-8550 Tokyo, Japan
Search for more papers by this authorTomohiko Matsuyama
Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorNatsuo Oya
Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorCorresponding Author
Hideo Baba
- [email protected]
- +81-96-373-5211
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Tel.: +81-96-373-5211, [email protected]Search for more papers by this authorYuki Kiyozumi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorNaoya Yoshida
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTakatsugu Ishimoto
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTaisuke Yagi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYuki Koga
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorTomoyuki Uchihara
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorHiroshi Sawayama
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYukiharu Hiyoshi
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorMasaaki Iwatsuki
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYoshifumi Baba
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorYuji Miyamoto
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorMasayuki Watanabe
Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, 135-8550 Tokyo, Japan
Search for more papers by this authorTomohiko Matsuyama
Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorNatsuo Oya
Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Search for more papers by this authorCorresponding Author
Hideo Baba
- [email protected]
- +81-96-373-5211
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556 Kumamoto, Japan
Tel.: +81-96-373-5211, [email protected]Search for more papers by this authorElectronic supplementary material: The online version of this article (https://doi.org/10.1007/s00268-018-4536-7) contains supplementary material, which is available to authorized users.
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.
Supporting Information
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| wjsbf08931-sup-0001.docxapplication/docx, 414 KB | Supplementary material 1 (DOCX 413 kb) |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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