[Esophagectomy combined resection of invaded neighboring organs for T4 esophageal carcinoma].

Advanced esophageal cancer, which invades into neighboring organs are classified as T4 esophageal cancer. Thoracic descending aorta, tracheobronchial tree, lung and pericardium are organs frequently invaded from esophageal cancer. Extended operation with combined resection of invaded neighboring organs such as aorta or tracheobronchhial tree were thought to be difficult and had high postoperative complications rates, mortality rates and poor prognosis. Therefore, this type of operation were not performed in the past except a few cases. However, recent progress in the fields of cardiovascular or general thoracic surgery, aortic replacement or tracheobronchial reconstruction become safety operation at present. Reports of extended operation of aortic or tracheobronchial resection for T4 esophageal cancer are increasing. Patients with T4 esophageal cancer are expected to have long term survival from extended operations when their cancer have no distant metastasis, and no or minor regional lymph node metastasis, are resected completely by combined resection of invaded neighboring organs, and responders to preoperative chemo and/or radiotherapy. Extended operation for T4 esophageal cancer will be considered as curative operation for very selected patients and improve the survival of the patients in the future.