Skip to main content
SpringerLink
Log in

Comparison of Salvage Total Pharyngolaryngectomy and Cervical Esophagectomy Between Hypopharyngeal Cancer and Cervical Esophageal Cancer

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Total pharyngolaryngectomy and cervical esophagectomy (TPLCE) after chemoradiotherapy remains a challenge because of the high rate of complications and few available data on outcomes and safety. The purpose of this study was to evaluate the clinical significance of salvage TPLCE and to compare treatment outcomes between hypopharyngeal cancer and cervical esophageal cancer.

Methods

Data from 37 consecutive patients who were diagnosed with potentially resectable hypopharyngeal and cervical esophageal cancer after chemoradiotherapy were retrospectively analyzed. The survival and surgical outcomes were investigated between the hypopharyngeal cancer and cervical esophageal cancer groups.

Results

Twenty-six patients were included in hypopharyngeal cancer group and 11 patients were included in cervical esophageal cancer group. The baseline characteristics were balanced between the two groups. Compared to the hypopharyngeal cancer group, the cervical esophageal cancer group had significantly more frequent tracheal-related complications (p < 0.05) and stronger association of distal margin of the cervical esophagus and radiation field with tracheal ischemia after salvage surgery.

Conclusions

Salvage TPLCE can offer the exclusive chance of prolonged survival. Association of tracheal ischemia with salvage TPLCE was seen more frequently for cervical esophageal cancer. Therefore, the indication for salvage TPLCE must be carefully considered to maintain the balance between curability and safety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gkika E, Gauler T, Eberhardt W, Stahl M, Stuschke M, Pottgen C. Long-term results of definitive radiochemotherapy in locally advanced cancers of the cervical esophagus. Dis Esophagus. 2013;27:678–84.

    Article  PubMed  Google Scholar 

  2. Suzuki K, Hayashi R, Ebihara M, et al. The effectiveness of chemoradiation therapy and salvage surgery for hypopharyngeal squamous cell carcinoma. Jpn J Clin Oncol. 2013;43:1210–7.

    Article  PubMed  Google Scholar 

  3. Tsou YA, Hua CH, Lin MH, Tseng HC, Tsai MH, Shaha A. Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer. Head Neck. 2010;32:1494–500.

    Article  PubMed  Google Scholar 

  4. Dirven R, Swinson BD, Gao K, Clark JR. The assessment of pharyngocutaneous fistula rate in patients treated primarily with definitive radiotherapy followed by salvage surgery of the larynx and hypopharynx. Laryngoscope. 2009;119:1691–5.

    Article  PubMed  Google Scholar 

  5. Mendenhall WM, Sombeck MD, Parsons JT Kasper ME, Stringer SP, Vogel SB. Management of cervical esophageal carcinoma. Semin Radiat Oncol. 1994;4:179–91.

    Article  CAS  PubMed  Google Scholar 

  6. Carvalho AL, Nishimoto IN, Califano JA, Kowalski LP. Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database. Int J Cancer. 2005;114:806–16.

    Article  CAS  PubMed  Google Scholar 

  7. Saeki H, Tsutsumi S, Yukaya T, et al. Clinicopathological features of cervical esophageal cancer: retrospective analysis of 63 consecutive patients who underwent surgical resection. Ann Surg. 2016. In press.

  8. Miyamoto S, Sakuraba M, Nagamatsu S, Hayashi R. Salvage total pharyngolaryngectomy and free jejunum transfer. Laryngoscope. 2001;121:947–51.

    Article  Google Scholar 

  9. Kadota H, Fukushima J, Nakashima T et al. Comparison of salvage and planned pharyngolaryngectomy with jejunal transfer for hypopharyngeal carcinoma after chemoradiotherapy. Laryngoscope. 2010;120:1103–8.

    PubMed  Google Scholar 

  10. Chang DW, Hussussian C, Lewin JS, Youssef AA, Robb GL, Reece GP. Analysis of pharyngocutaneous fistula following free jejunal transfer for total laryngopharyngectomy. Plast Reconstr Surg. 2002;109:1522–7.

    Article  PubMed  Google Scholar 

  11. McCaffrey TV, Fisher J. Effect of radiotherapy on the outcome of pharyngeal reconstruction using free jejunal transfer. Ann Otol Rhinol Laryngol. 1987;96:22–5.

    Article  CAS  PubMed  Google Scholar 

  12. Japanese Research Society for Esophageal Diseases. Japanese classification of esophageal cancer. 2nd English ed. Tokyo: Kanehara; 2008.

    Google Scholar 

  13. Japan Society for Head and Neck Cancer. General rules for clinical studies on head and neck cancer. 5th ed. Tokyo: Kanehara; 2012. pp. 58–65.

    Google Scholar 

  14. Mayanagi S, Onitsuka T, Nakagawa M, Sato H, Kitagawa Y, Tsubosa Y. The use of short segment free jejunal transfer as salvage surgery for cervical esophageal and hypopharyngeal cancer. World J Surg. 2014;38:144–9.

    Article  PubMed  Google Scholar 

  15. Ajani JA, Bentrem DJ, Besh S, et al. Esophageal and esophagogastric junction cancers (excluding the proximal 5 cm of the stomach). National Comprehensive Cancer Network clinical practice guidelines in oncology. 2015;13(2):194–227.

  16. Teoh AY, Chiu PW, Yeung WK, Liu SY, Wong SK, Ng EK. Longterm survival outcomes after definitive chemoradiation versus surgery in patients with resectable squamous carcinoma of the esophagus: results from a randomized controlled trial. Ann Oncol. 2013;24:165–71.

    Article  CAS  PubMed  Google Scholar 

  17. Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol. 2007;25:1160–8.

    Article  CAS  PubMed  Google Scholar 

  18. Wakui R, Yamashita H, Okuma K, et al. Esophageal cancer: definitive chemoradiotherapy for elderly patients. Dis Esophagus. 2010;23:572–9.

    Article  CAS  PubMed  Google Scholar 

  19. Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trials (RTOG 85-01)—radiation therapy oncology group. JAMA. 1999;281:1623–7.

    Article  CAS  PubMed  Google Scholar 

  20. Minsky BD, Pajak TF, Ginsberg RJ, et al. INT 0123 (radiation therapy oncology group 94-05) phase III trial of combined modality therapy for esophageal cancer: high-dose versus standard dose radiation therapy. J Clin Oncol. 2002;20:1167–74.

    Article  CAS  PubMed  Google Scholar 

  21. Brockstein B, Haraf DJ, Rademaker AW et al. Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol. 2004;15:1179–86.

    Article  CAS  PubMed  Google Scholar 

  22. Salama JK, Seiwert TY, Vokes EE. Chemoradiotherapy for locally advanced head and neck cancer. J Clin Oncol. 2007;25:4118–26.

    Article  CAS  PubMed  Google Scholar 

  23. Takeuchi S, Ohtsu A, Doi T, et al. A retrospective study of definitive chemoradiotherapy for elderly patients with esophageal cancer. Am J Clin Oncol. 2007;30:607–11.

    Article  PubMed  Google Scholar 

  24. Gardner-Thorpe J, Hardwick RH, Dwerryhouse SJ. Salvage oesophagectomy after local failure of definitive chemoradiotherapy. Br J Surg. 2007;94:1059–66.

    Article  CAS  PubMed  Google Scholar 

  25. Fujiki M, Miyamoto S, Sakuraba M, Nagamatsu S, Hayashi R. Risk factors for tracheal necrosis after total pharyngolaryngectomy. Head Neck. 2015;37:1207–10.

    Article  PubMed  Google Scholar 

  26. Salassa JR, Pearson BW, Payne WS. Gross and microscopical blood supply of the trachea. Ann Thorac Surg. 1977;24:100–7.

    Article  CAS  PubMed  Google Scholar 

  27. Booka E, Tsubosa Y, Niihara M, et al. Risk factors for complications after pharyngolaryngectomy with total esophagectomy. Esophagus. 2016. In press.

  28. Markar S, Gronnier C, Duhamel A, et al. Salvage surgery after chemoradiotherapy in the management of esophageal cancer: is it a viable therapeutic option? J Clin Oncol. 2015;33:3866–73.

    Article  CAS  PubMed  Google Scholar 

Download references

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Katsushi Takebayashi MD, PhD, Yasuhiro Tsubosa MD, PhD, Masahiro Niihara MD, PhD, Eisuke Booka MD, PhD & Ayako Shimada MD

  2. Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Katsushi Takebayashi MD, PhD, Tomoyuki Kamijo MD, PhD, Yoshiyuki Iida MD, Atsushi Imai MD, PhD, Masato Nagaoka MD, Takashi Kitani MD & Tetsuro Onitsuka MD, PhD

  3. Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Masahiro Nakagawa MD, PhD

Authors
  1. Katsushi Takebayashi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuhiro Tsubosa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomoyuki Kamijo MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshiyuki Iida MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Atsushi Imai MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masato Nagaoka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Kitani MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masahiro Niihara MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eisuke Booka MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ayako Shimada MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Masahiro Nakagawa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Tetsuro Onitsuka MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoyuki Kamijo MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takebayashi, K., Tsubosa, Y., Kamijo, T. et al. Comparison of Salvage Total Pharyngolaryngectomy and Cervical Esophagectomy Between Hypopharyngeal Cancer and Cervical Esophageal Cancer. Ann Surg Oncol 24, 778–784 (2017). https://doi.org/10.1245/s10434-016-5474-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-016-5474-y

Keywords

Search

Navigation