Eleonora Farinella1, Adonis Safar2, Haydar A Nasser2, Fikri Bouazza2, Gabriele Liberale2, Marianne Paesmans3, Raphael Marechal4, Jean-Luc Van Laethem4, Alain Hendlisz5, Paul VanHoutte6, Issam El Nakadi2. 1. Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium. eleonorafarinella@yahoo.it. 2. Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium. 3. Data Center, Institut Jules Bordet, Center des Tumeurs ULB Bruxelles, Bruxelles, Belgium. 4. Department of Gastroenterology, GI Cancer Unit, ULB-Erasme, Bruxelles, Belgium. 5. Department of Medical Oncology, Institut Jules Bordet, Bruxelles, Belgium. 6. Department of Radiotherapy, Institut Jules Bordet, Bruxelles, Belgium.
Abstract
BACKGROUND: Definitive radiochemotherapy (dRCT) in locally advanced esophageal cancer is associated with a high rate of loco-regional recurrence. In this condition, salvage esophagectomy may be considered as a therapeutic option. The aim of this analysis is to evaluate the feasibility and the morbi-mortality of this strategy. METHODS: Between January 2006 and April 2014, 208 patients underwent esophagectomy for esophageal cancer at ULB-Erasme-Bordet. Thirty-two patients received a preoperative radiochemotherapy (pRCT) followed by planned esophagectomy (Group 1) for locally advanced disease. Sixteen patients underwent salvage esophagectomy for recurrence or failure after dRCT (Group 2). Data on post-operative morbidity and mortality and survival were collected and analyzed. RESULTS: An increase of overall morbidity was detected in Group 2 as compared to Group 1 (43% vs. 37.5%), mainly related to respiratory complications (35.5% vs. 28%) and anastomotic leak (25% vs. 3%). No 90-days mortality was observed in the two surgical groups. The 1, 2, and 3-year survival rates after surgery were respectively 89%, 80%, and 71% for Group1 and 84%, 73%, and 63% for Group 2. CONCLUSIONS: In our experience, both salvage esophagectomy and esophagectomy after pRCT showed good survival results with low postoperative morbidity and mortality. Salvage surgery remains a therapeutic indication in selected patients. J. Surg. Oncol. 2016;114:833-837.
BACKGROUND: Definitive radiochemotherapy (dRCT) in locally advanced esophageal cancer is associated with a high rate of loco-regional recurrence. In this condition, salvage esophagectomy may be considered as a therapeutic option. The aim of this analysis is to evaluate the feasibility and the morbi-mortality of this strategy. METHODS: Between January 2006 and April 2014, 208 patients underwent esophagectomy for esophageal cancer at ULB-Erasme-Bordet. Thirty-two patients received a preoperative radiochemotherapy (pRCT) followed by planned esophagectomy (Group 1) for locally advanced disease. Sixteen patients underwent salvage esophagectomy for recurrence or failure after dRCT (Group 2). Data on post-operative morbidity and mortality and survival were collected and analyzed. RESULTS: An increase of overall morbidity was detected in Group 2 as compared to Group 1 (43% vs. 37.5%), mainly related to respiratory complications (35.5% vs. 28%) and anastomotic leak (25% vs. 3%). No 90-days mortality was observed in the two surgical groups. The 1, 2, and 3-year survival rates after surgery were respectively 89%, 80%, and 71% for Group1 and 84%, 73%, and 63% for Group 2. CONCLUSIONS: In our experience, both salvage esophagectomy and esophagectomy after pRCT showed good survival results with low postoperative morbidity and mortality. Salvage surgery remains a therapeutic indication in selected patients. J. Surg. Oncol. 2016;114:833-837.
Authors: Arianna Barbetta; Meier Hsu; Kay See Tan; Dessislava Stefanova; Koby Herman; Prasad S Adusumilli; Manjit S Bains; Matthew J Bott; James M Isbell; Yelena Y Janjigian; Geoffrey Y Ku; Bernard J Park; Abraham J Wu; David R Jones; Daniela Molena Journal: J Thorac Cardiovasc Surg Date: 2018-02-15 Impact factor: 5.209