Esophagectomy for esophageal cancer in patients with a history of total pharyngolaryngectomy: a Japanese nationwide retrospective cohort study.

Autor: Okamura A; Department of Esophageal Surgery, Gastroenterology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan., Watanabe M; Department of Esophageal Surgery, Gastroenterology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. masayuki.watanabe@jfcr.or.jp., Okui J; Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan.; Department of Surgery, School of Medicine, Keio University, Tokyo, Japan., Kuriyama K; Department of Esophageal Surgery, Gastroenterology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan., Shiraishi O; Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan., Kurogochi T; Division of Gastrointestinal Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan., Abe T; Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan., Sato H; Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan., Miyata H; Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan., Kawaguchi Y; First Department of Surgery, Faculty of Medicine, University of Yamanashi, Kofu, Yamanashi, Japan., Sato Y; Esophageal Surgery, Akita University Hospital, Akita, Japan., Nagano H; Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan., Takeno S; Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan., Nakajima M; Department of Upper Gastrointestinal Surgery, Dokkyo Medical University, Tochigi, Japan., Matsuo K; Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan., Murakami K; Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan., Takebayashi K; Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan., Matsumoto S; Department of Surgery, Nara Medical University, Nara, Japan., Okumura T; Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan., Kakeji Y; Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan., Kono K; Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan., Oridate N; Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan., Toh Y; Department of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan., Takeuchi H; Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan., Katori Y; Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Jazyk: angličtina
Zdroj: Esophagus : official journal of the Japan Esophageal Society [Esophagus] 2024 Oct; Vol. 21 (4), pp. 438-446. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1007/s10388-024-01078-4
Abstrakt: Background: Second primary esophageal cancer often develops in patients with head and neck cancer, and esophagectomy in patients with a history of total pharyngolaryngectomy (TPL) is challenging. However, the clinical outcomes of these patients have yet to be examined in a multicenter setting.
Methods: We evaluated the surgical outcomes of a nationwide cohort of 62 patients who underwent esophagectomy for esophageal cancer with a history of TPL.
Results: Ivor-Lewis and McKeown esophagectomies were performed in 32 (51.6%) and 30 (48.4%) patients, respectively. Postoperatively, 23 patients (37.1%) developed severe complications, and 7 patients (11.3%) required reoperation within 30 days. Pneumonia and anastomotic leakage occurred in 13 (21.0%) and 16 (25.8%) patients, respectively. Anastomotic leakage occurred more frequently in the McKeown group than in the Ivor-Lewis group (46.7% vs. 6.2%, P < 0.001). The adjusted odds ratio for anastomotic leakage in the McKeown group was 9.64 (95% confidence intervals (CI), 2.11-70.82, P = 0.008). Meanwhile, the 5-year overall survival rates were comparable between the groups (41.8% for Ivor-Lewis and 42.7% for McKeown), and the adjusted hazard ratio of overall survival was 1.44 (95% CI, 0.64-3.29; P = 0.381; Ivor-Lewis as the reference).
Conclusions: In our cohort, anastomotic leakage occurred more frequently after McKeown than Ivor-Lewis esophagectomy, and almost half of patients in the McKeown group experienced leakage. Ivor-Lewis esophagectomy is preferred for decreasing anastomotic leakage when oncologically and technically feasible.
(© 2024. The Author(s) under exclusive licence to The Japan Esophageal Society.)
Databáze: MEDLINE
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