Observational studyEsophagus : official journal of the Japan Esophageal Society2020
Salvage esophagectomy for initially unresectable locally advanced T4 esophageal squamous cell carcinoma.
Observational study in Esophagus : official journal of the Japan Esophageal Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Can combined organ resection cure T4 esophageal cancer? Insights from a multi-institutional study of incomplete resection cases.Esophagus : official journal of the Japan Esophageal Society · 2026Observational
- Retrospective analysis of postoperative adjuvant therapy and survival in T4 esophageal squamous cell carcinoma: a dual-cohort study using SEER and Chinese multicenter data.Frontiers in medicine · 2026Article
- Observational
- Salvage esophagectomy for unresectable locally advanced esophageal squamous cell carcinoma: Significant or not?Annals of gastroenterological surgery · 2025Review
- Endobronchial Ultrasonography to Assess and Evaluate Tracheobronchial Tree Invasion in cT4b Esophageal Cancer Patients Treated with Definitive Chemoradiotherapy: Assessment of Resectability.Annals of surgical oncology · 2025Article
- Thoracoscopic salvage esophagectomy with prophylactic mediastinal lymph node dissection after definitive chemoradiotherapy for patients with esophageal cancer.Surgical endoscopy · 2024Article
- Article
- Comparison of immunochemotherapy and chemotherapy alone in conversion therapy for locally advanced unresectable esophageal squamous cell carcinoma.Frontiers in oncology · 2024Article
- Article
- Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: part 1.Esophagus : official journal of the Japan Esophageal Society · 2023Article
- Essential updates 2020/2021: Recent topics in surgery and perioperative therapy for esophageal cancer.Annals of gastroenterological surgery · 2023Review
- Efficacy of thoracotomy and thoracoscopic-assisted esophageal surgery in conversion and salvage surgeries: a retrospective study.World journal of surgical oncology · 2022Article
- Progression-free survival as surrogate endpoint of overall survival in esophageal squamous cell carcinoma: a real-world data and literature-based analysis.Therapeutic advances in medical oncology · 2022Article
- Surgical strategies for treatment of clinical T4 esophageal cancer in Japan.Global health & medicine · 2021Review
- Salvage treatment after definitive chemoradiotherapy for esophageal squamous cell carcinoma.Annals of gastroenterological surgery · 2021Review
- Salvage Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) for T4b Esophageal Cancer After Definitive Chemoradiotherapy.Annals of surgical oncology · 2021Article
- Unresectable esophageal cancer treated with multiple chemotherapies in combination with chemoradiotherapy: A case report.World journal of clinical cases · 2021Article
- Long-Term Outcome of Patients with Locally Advanced Clinically Unresectable Esophageal Cancer Undergoing Conversion Surgery after Induction Chemotherapy with Docetaxel Plus Cisplatin and 5-Fluorouracil.Annals of surgical oncology · 2021Article
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8 authors.
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Abstract
backgroundDefinitive chemoradiotherapy (dCRT) for esophageal squamous cell carcinoma (ESCC) is a potentially curative treatment modality, even for patients with unresectable T4 tumors. For patients who fail dCRT, salvage esophagectomy is known to be a high-risk procedure. However, the efficacy and safety of salvage surgery for these patients remain unclear.
methodsA total of 35 patients who underwent salvage esophagectomy after dCRT for initially unresectable locally advanced T4 ESCC were assessed, and both outcomes and prognostic factors after surgery were investigated.
resultsAmong the study population, R0 resection was achieved in 19 patients (54.3%). Postoperatively, 8 patients (22.9%) experienced Clavien-Dindo grade IIIb or higher complications, and 3 patients (8.6%) registered surgery-related mortality. Overall survival rates were 45.7%, 28.6%, and 5.7% at 1, 2, and 5 years, respectively. In Cox regression analysis, residual or relapsed tumor limited to T2 or less was an independent prognostic factor for better survival (P = 0.010). On the other hand, postoperative pneumonia and incomplete resection were negative prognostic factors (P < 0.001 and P = 0.019, respectively). Nodal involvement and extent of lymph node dissection did not impact patient survival.
conclusionsAlthough salvage esophagectomy for initially unresectable T4 ESCC is considered a high-risk surgery with poor prognosis, long-term survival may be achieved in patients with ≤ T2 residual tumors. In addition, R0 resection and postoperative pneumonia prevention are crucial to improve patient survival.
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