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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Head and Neck Oncology

Short- and Long-Term Outcomes of Larynx-Preserving Surgery for Cervical Esophageal Cancer: Analysis of 100 Consecutive Cases

Authors: Tomoki Makino, MD, PhD, Makoto Yamasaki, MD, PhD, Yasuhiro Miyazaki, MD, PhD, Tsuyoshi Takahashi, MD, PhD, Yukinori Kurokawa, MD, PhD, Kiyokazu Nakajima, MD, PhD, Shuji Takiguchi, MD, PhD, Masaki Mori, MD, PhD, Yuichiro Doki, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

Background

Surgical interventions for cervical esophageal cancer (CEC), particularly larynx-preserving procedures, have not yet been standardized in terms of short- and long-term outcome.

Methods

We retrospectively analyzed 100 consecutive surgeries for CEC in our department. We compared clinicopathological parameters and long-term outcomes between larynx-preserving esophagectomies (LP group) and nonpreserving procedures (NP group). We also evaluated preoperative predictive parameters for larynx-preservation.

Results

Compared with the NP group, the LP group had significantly lower cT (P < 0.001) and cStage (P = 0.001) and shorter tumor length (P = 0.0108). Multivariate logistic regression analysis identified early cT stage, early cStage, and response to preoperative treatment as significant predictive parameters of larynx preservation. Larynx-preserving procedures could be performed for 90.5 % of T1–2 tumors regardless of preoperative treatment response. In contrast in T3–4 tumors, most nonresponders (92.3 %) were ineligible for larynx-preservation (P = 0.0012), whereas 54.3 % of responders could achieve larynx preservation. The average shortening of upward extension in T3–4 tumors after preoperative treatment was 20.0 mm in the LP group vs. 10.2 mm in the NP group (P = 0.051). The two groups were similar in terms of overall morbidity (including pneumonia), mortality, and postoperative hospital days. Importantly, larynx preservation for CEC neither worsened patient prognosis nor increased locoregional recurrence compared to the NP group.

Conclusions

Larynx-preserving esophagectomy for CEC is feasible and oncologically acceptable. The cT, cStage, and clinical response to preoperative treatment are important preoperative predictors of a patient’s suitability for larynx-preservation.
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Metadata
Title
Short- and Long-Term Outcomes of Larynx-Preserving Surgery for Cervical Esophageal Cancer: Analysis of 100 Consecutive Cases
Authors
Tomoki Makino, MD, PhD
Makoto Yamasaki, MD, PhD
Yasuhiro Miyazaki, MD, PhD
Tsuyoshi Takahashi, MD, PhD
Yukinori Kurokawa, MD, PhD
Kiyokazu Nakajima, MD, PhD
Shuji Takiguchi, MD, PhD
Masaki Mori, MD, PhD
Yuichiro Doki, MD, PhD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5511-x

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