Salvage Surgery in the Management of Esophageal Cancer

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Persistent esophageal cancer after definitive chemoradiotherapy has poorer survival when compared with recurrent cancer.
Persistent esophageal cancer after definitive chemoradiotherapy has poorer survival when compared with recurrent cancer.

Persistent esophageal cancer after definitive chemoradiotherapy has poorer survival when compared with recurrent cancer, stated an article printed online ahead of print in the Journal of Clinical Oncology.

Researchers assessed the impact of salvage esophagectomy after definitive chemoradiotherapy (SALV) on clinical outcomes in a large multicenter study that included data from consecutive adult patients undergoing resection for esophageal cancer in 30 European centers from 2000 to 2010.

Patients undergoing SALV (n=308) and neoadjuvant chemotherapy followed by planned esophagectomy (NCRS; n=540) were compared.

Next, patients who benefitted from SALV for persistent (n=234) versus patients with recurrent disease (n=74).

In-hospital mortality was similar between both groups. Significant differences in complications were seen for anastomotic leak (17.2% vs 10.7%), as well as surgical site infection, which was more common in the SALV group.

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At 3 years, overall survival (40.9% vs 56.2%; P=.046) and disease-free survival (36.6% vs 51.6%; P=0.095) were lower in the persistent group. 

Results suggest that (SALV) offered acceptable short- and long-term outcomes in selected patients in experienced centers.

Reference

  1. Markar S, Gronnier C, Duhamel A, et al. Salvage surgery after chemoadiotherapy in the management of esophageal cancer: is it a viable therapeutic option? J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2014.59.9092.

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