Salvage surgery for recurrent carcinoma of the cervical esophagus postesophagectomy

Head Neck. 2015 Aug;37(8):1170-5. doi: 10.1002/hed.23730. Epub 2014 Jul 11.

Abstract

Background: Management of cervical esophageal tumor postesophagectomy is mainly palliative because of inadequate exposure of tumor in the cervicothoracic region. In this study, we propose a means of cure for these patients.

Methods: Between January 2003 and June 2013, 6 patients underwent curative pharyngolaryngectomy and completion cervical esophagectomy via manubrial resection. Operative outcomes were analyzed and compared with a historical cohort who received palliative therapy.

Results: One patient required prolonged hospital stay for pneumonia, resulting in a median hospital stay of 30 days (range, 21-55 days). All patients resumed oral feeding at a mean of 15.2 days (range, 14-19 days). Tracheostoma stenosis was noted in 2 patients. One patient developed nodal recurrence, another with distant metastasis, resulting in a median disease-free survival of 13 months (range, 4-20 months). Median overall survival was significantly longer than the cohort group (19.0 vs 3.0 months; p = .013).

Conclusion: Salvage surgery in patients with carcinoma of the cervical esophagus postesophagectomy is feasible with significantly prolonged survival.

Keywords: cervical esophagus; postesophagectomy; recurrence; salvage.

MeSH terms

  • Aged
  • Carcinoma / mortality
  • Carcinoma / surgery*
  • Constriction, Pathologic
  • Disease-Free Survival
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy*
  • Feasibility Studies
  • Humans
  • Laryngectomy
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery*
  • Pharyngectomy
  • Retrospective Studies
  • Risk Factors
  • Salvage Therapy* / methods
  • Tracheostomy / adverse effects
  • Treatment Outcome