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Salvage Surgery for Recurrent Disease after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

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

Abstract

Background

Outcomes of salvage surgery after failed definitive chemoradiation (CRT) for esophageal cancer have been well defined. However, only a few studies have focused on salvage esophagectomy for recurrent disease after CRT.

Methods

In 227 patients with esophageal cancer who underwent salvage esophagectomy after definitive CRT, consisting of 116 patients who underwent esophagectomy for persistent disease (the persistent group) and 111 patients who underwent esophagectomy for recurrent disease (the recurrent group), the short- and long-term outcomes were investigated.

Results

The rates of any postoperative complication were similar between the groups (49.1% in the persistent group vs. 49.5% in the recurrent group, p = 0.951), although there was a higher rate of anastomotic leakage in the recurrent group (p = 0.027). Thirty-day mortality was also similar between the groups (1.7% in the persistent group vs. 0.9% in the recurrent group, p = 0.587). The 3-year and 5-year overall survival rates were 33.7% and 28.0% in the persistent group and 48.7% and 41.7% in the recurrent group, respectively (p = 0.0175). In the recurrent group, clinically nodal status before CRT as well as pathologically nodal status and time to relapse were identified as independent prognostic factors. In the persistent group, pT and resection margin were identified as independent factors associated with survival.

Conclusions

The present study showed that salvage surgery for recurrent disease can provide acceptable short- and long-term outcomes. Considering clinically and pathologically nodal status and time to relapse, adjuvant therapy might be offered for patients who underwent salvage esophagectomy for recurrent disease after definitive CRT.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan

    Hiroshi Miyata MD, Keijiro Sugimura MD, Takashi Kanemura MD, Tomohira Takeoka MD & Takahito Sugase MD

  2. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Koji Tanaka MD, Tomoki Makino MD, Kotaro Yamashita MD, Makoto Yamasaki MD & Yuichiro Doki MD

  3. Department of Surgery, Osaka General Medical Center, Osaka, Japan

    Masaaki Motoori MD & Masahiko Yano MD

  4. Department of Surgery, Kinki University, Osaka, Japan

    Osamu Shiraishi MD, Yutaka Kimura MD & Takushi Yasuda MD

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  1. Hiroshi Miyata MD
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  15. Yuichiro Doki MD
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Correspondence to Hiroshi Miyata MD.

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Miyata, H., Sugimura, K., Kanemura, T. et al. Salvage Surgery for Recurrent Disease after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 29, 5657–5665 (2022). https://doi.org/10.1245/s10434-022-11802-y

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