Surgical management of carcinoma of the cervical esophagus

Objectives The aim of the present study was to clarify the clinicopathological characteristics, reconstruction methods after resection, and prognosis of cervical esophageal squamous cell carcinoma. Methods Seventy‐four with squamous cell carcinomas of the cervical esophagus not previously treated wh...

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Published in:Journal of surgical oncology 2007-08, Vol.96 (2), p.166-172
Main Authors: Daiko, Hiroyuki, Hayashi, Ryuichi, Saikawa, Masahisa, Sakuraba, Minoru, Yamazaki, Mitsuo, Miyazaki, Masakazu, Ugumori, Toru, Asai, Masahiro, Oyama, Waichiro, Ebihara, Satoshi
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
cervical esophageal squamous cell carcinoma
Chemotherapy, Adjuvant
Cisplatin - administration & dosage
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagectomy - mortality
Esophagoplasty - methods
Esophagoplasty - mortality
Female
free jejunal transfer
gastric pull-up
Hospital Mortality
Humans
Jejunum - transplantation
Laryngectomy
Lymph Nodes - pathology
Male
Middle Aged
Postoperative Complications
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
Stomach - surgery
Survival Rate
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Summary:Objectives The aim of the present study was to clarify the clinicopathological characteristics, reconstruction methods after resection, and prognosis of cervical esophageal squamous cell carcinoma. Methods Seventy‐four with squamous cell carcinomas of the cervical esophagus not previously treated who underwent cervical esophagectomy or total esophagectomy with or without laryngectomy were retrospectively analyzed. Results The operative morbidity and in‐hospital mortality rates were 34% (25 patients) and 4% (3 patients), respectively. Alimentary continuity was achieved with free jejunal transfer (50 patients), gastric pull‐up (19 patients), and other procedures (5 patients). The frequencies of postoperative complications and death did not differ between free jejunal transfer and gastric pull‐up. The overall 3‐ and 5‐year survival rates were 42% and 33%, respectively. The significant clinicopathological factors affecting survival were patient gender, high T factor, lymph node involvement, palpable cervical lymph nodes, vocal cord paralysis, lymphatic invasion, and extracapsular invasion. The pattern of first failure was most often locoregional (82%, 36 patients). Conclusion The choice of free jejunal transfer or gastric pull‐up for reconstruction after surgical resection of cervical esophageal carcinoma depends on the degree of tumor extension. Adverse factors affecting survival should be considered when candidates for the surgery are selected. J. Surg. Oncol. 2007;96:166–172. © 2007 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.20795