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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2014

01-04-2014 | Thoracic Oncology

Surgical Resection of Hypopharynx and Cervical Esophageal Cancer with a History of Esophagectomy for Thoracic Esophageal Cancer

Authors: Satoshi Ida, MD, PhD, Masaru Morita, MD, PhD, FACS, Yukiharu Hiyoshi, MD, PhD, Keisuke Ikeda, MD, Koji Ando, MD, PhD, Yasue Kimura, MD, PhD, Hiroshi Saeki, MD, PhD, Eiji Oki, MD, PhD, Tetsuya Kusumoto, MD, PhD, Sei Yoshida, MD, PhD, Torahiko Nakashima, MD, PhD, Masayuki Watanabe, MD, PhD, FACS, Hideo Baba, MD, PhD, FACS, Yoshihiko Maehara, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 4/2014

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Abstract

Background

Cancer of the hypopharynx and cervical esophagus (PhCe cancer) frequently develops synchronously or metachronously with esophageal cancer. The surgical approach is usually difficult, especially in metachronous PhCe cancer after esophagectomy. The purpose of this study was to clarify the treatment outcomes of patients with metachronous PhCe cancer with a history of esophagectomy.

Methods

The subjects evaluated in this study were 14 patients with metachronous PhCe cancer who underwent pharyngo-laryngo-esophagectomy after subtotal esophagectomy and gastric tube pull-up for primary esophageal cancer.

Results

Definitive chemoradiotherapy (CRT; radiation dose >50 Gy) was performed for primary laryngeal (n = 1), pharyngeal (n = 2), esophageal (n = 1), and recurrent esophageal cancer (n = 2). For seven patients with metachronous PhCe cancer, induction CRT (radiation dose <40 Gy) was performed. In all 14 patients, pharyngo-laryngo-esophagectomy was followed by free jejunal graft interposition with reconstruction of the jejunal vessels. Although postoperative complications developed in four patients, no perioperative death or necrosis of the reconstructed free jejunum occurred. The 2- and 5-year overall survival rates were 84 and 50 %, respectively.

Conclusions

Pharyngo-laryngo-esophagectomy with free jejunal transfer is considered to be safe for metachronous PhCe cancer, even in patients with a history of CRT and esophagectomy.
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Metadata
Title
Surgical Resection of Hypopharynx and Cervical Esophageal Cancer with a History of Esophagectomy for Thoracic Esophageal Cancer
Authors
Satoshi Ida, MD, PhD
Masaru Morita, MD, PhD, FACS
Yukiharu Hiyoshi, MD, PhD
Keisuke Ikeda, MD
Koji Ando, MD, PhD
Yasue Kimura, MD, PhD
Hiroshi Saeki, MD, PhD
Eiji Oki, MD, PhD
Tetsuya Kusumoto, MD, PhD
Sei Yoshida, MD, PhD
Torahiko Nakashima, MD, PhD
Masayuki Watanabe, MD, PhD, FACS
Hideo Baba, MD, PhD, FACS
Yoshihiko Maehara, MD, PhD, FACS
Publication date
01-04-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3454-z

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