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01-05-2018 | Original Scientific Report

Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer

Authors: Akira Matsumoto, Yuji Kanaoka, Takeshi Baba, Reo Takizawa, Masayuki Hara, Koji Maeda, Katsunori Nishikawa, Yutaka Suzuki, Katsuhiko Yanaga, Takao Ohki

Published in: World Journal of Surgery | Issue 5/2018

Abstract

Background

Bleeding from the thoracic aorta is potentially fatal in patients with advanced esophageal cancer. Thoracic endovascular aortic repair (TEVAR) was recently applied for aortic invasion by esophageal cancer. However, only a few case reports have been published. This study was performed to clarify the effectiveness and safety of TEVAR for patients with advanced esophageal cancer.

Methods

We retrospectively reviewed 18 patients who underwent TEVAR for esophageal cancer. We also performed a literature search and reviewed 21 similar cases.

Results

From 2007 to 2016, 10 patients were treated on an emergent basis for aortic hemorrhage (salvage group) and 8 patients underwent urgent prophylactic surgery (prophylactic group). Hemostasis was achieved in all cases. One (10%) patient in the salvage group died of aspiration pneumonia on postoperative day 1, while all patients in the prophylactic group survived for >1 month. The median survival period in the salvage and prophylactic group was 3.25 and 11.10 months, respectively. The longest survivor was still alive 9 years after TEVAR and chemoradiotherapy. No fatal adverse events or negative impacts on subsequent treatment for esophageal cancer occurred.

Conclusions

TEVAR is feasible, safe, and effective in preventing fatal aortic hemorrhage secondary to esophageal cancer invasion, although it is palliative in most cases. Because the outcomes of emergent TEVAR after bleeding tended to be worse in the salvage than in prophylactic group, prophylactic TEVAR may be considered a viable treatment option for patients with aortic invasion by advanced esophageal cancer.

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Title: Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer
Authors: Akira Matsumoto
Yuji Kanaoka
Takeshi Baba
Reo Takizawa
Masayuki Hara
Koji Maeda
Katsunori Nishikawa
Yutaka Suzuki
Katsuhiko Yanaga
Takao Ohki
Publication date: 01-05-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 5/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4334-7

At a glance: The STEP trials

Springer Medicine

Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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