Modified En Bloc Esophagectomy for Squamous Cell Carcinoma After Neoadjuvant Chemoradiotherapy

Po Kuei Hsu*, Ling I. Chien, Lin Chi Chuang, Yi Ying Lee, Chien Sheng Huang, Han Shui Hsu, Yu Chung Wu, Wen Hu Hsu

*此作品的通信作者

研究成果: Article同行評審

摘要

Background: The optimal type of esophagectomy and extent of lymphadenectomy for patients after neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma remain controversial. We hypothesized that a more radical resection is associated with better survival. Methods: Data of patients who received nCRT followed by resection for esophageal squamous cell carcinoma between 2012 and 2021 were analyzed. Modified en bloc esophagectomy (mEBE) involves total mediastinal lymphadenectomy and resection of all periesophageal node-bearing tissues. Perioperative outcomes and survival rates of mEBE were compared with those of conventional esophagectomy (CE). Results: A total of 238 patients were included. Compared with CE, mEBE was associated with a longer operative time, higher total number of resected lymph nodes, fewer complications, and less anastomotic leakage; length of stay was similar between the 2 groups. There was no difference in overall survival rates between patients with ypT0 N0 stage in the mEBE and CE groups; however, in patients with non–ypT0 N0 stage in the mEBE and CE groups, the 3-year overall survival rates were 58.5% and 28.5%, respectively (P < .001). On disease-free survival analysis, no difference was observed in patients with ypT0 N0 stage, whereas patients with non–ypT0 N0 stage after nCRT had significantly better disease-free survival after mEBE compared with CE (49.7% vs 27.2%; P = .017). Conclusions: Survival after mEBE was significantly better than that after CE. The mEBE did not increase postoperative hospital stay and complication rates.

原文English
頁(從 - 到)862-869
頁數8
期刊Annals of Thoracic Surgery
115
發行號4
DOIs
出版狀態Published - 4月 2023

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