Salvage esophagectomy: safe therapeutic strategy?
File(s)jtd-09-S8-S799.pdf (862.93 KB)
Published version
Author(s)
Jamel, Sara
Markar, Sheraz R
Type
Journal Article
Abstract
The objectives of this review were to assess both the short- and long-term clinical outcomes in patients managed with definitive chemoradiotherapy, and salvage esophagectomy subsequently in comparison to those neoadjuvant chemoradiotherapy followed by planned esophagectomy (NCRS) for esophageal cancer from published literature. Eleven studies comprising 1,906 patients were included, 563 in the salvage group and 1,343 in the NCRS group. Pooled analysis showed no significant difference between salvage and NCRS groups in overall survival [hazard ratio (HR) =1.17; 95% confidence interval (95% CI), 0.94-1.46, P=0.148], postoperative mortality [pooled odds ratios (POR) =1.12; 95% CI, 0.52-2.41, P=0.775], pulmonary complications (POR =1.24; 95% CI, 0.83-1.86, P=0.292) and positive resection margin incidence (POR =1.29; 95% CI, 0.94-1.76, P=0.114). However, within the salvage group there were increases in postoperative morbidity (POR =1.30; 95% CI, 1.00-1.67, P=0.046) and anastomotic leak (POR =1.88; 95% CI, 1.41-2.51, P<0.001). Herein we found that salvage esophagectomy has similar short- and long-term mortality in comparison to planned esophagectomy following neoadjuvant chemoradiotherapy. However, anastomotic leak is increased following salvage esophagectomy suggesting the need for this practice to be reserved for high volume surgeons within high volume centers.
Date Issued
2017-07-01
Date Acceptance
2017-03-30
Citation
Journal of thoracic disease, 2017, 9 (Suppl 8), pp.S799-S808
ISSN
2077-6624
Publisher
Pioneer Bioscience Publishing Company (PBPC)
Start Page
S799
End Page
S808
Journal / Book Title
Journal of thoracic disease
Volume
9
Issue
Suppl 8
Copyright Statement
© Journal of Thoracic Disease. All rights reserved
Identifier
PII: jtd-09-S8-S799
Subjects
Esophageal cancer
chemotherapy
definitive chemotherapy
neoadjuvant chemotherapy
salvage esophagectomy
Publication Status
Published