Surgical resection is considering the gold standard in esophageal cancer treatment, with 15–40% cure global rates. Radical exclusive chemoradiotherapy (CRT) is used in patients with local advanced esophageal cancer or… Click to show full abstract
Surgical resection is considering the gold standard in esophageal cancer treatment, with 15–40% cure global rates. Radical exclusive chemoradiotherapy (CRT) is used in patients with local advanced esophageal cancer or without clinical conditions for esophagectomy, with a 5-year overall survival up to 30%. However, locoregional control is poor with a 40–60% recurrence rate and salvage esophagectomy maybe an option for these patients. Our objective is to report the experience of a single high volume oncological institution with salvage esophagectomy. Retrospective analysis of 28 patients medical records, with esophageal cancer, submitted to Salvage Esophagectomy in Brazilian NCI after radical exclusive CRT or RT between January 1990 and December 2015. Median age was 56 years and most are male (78,5%). Esophageal middle third was the tumor principal location (50%) and histological type was squamous cell carcinoma (82%). Thoracic approach for esophagectomy was the principal surgical technique, and gastric tube the most used conduit for reconstruction (78,5%). Surgery was R0 in 83% of the cases, with a surgical morbidity of 64%. Median hospital time was 15 days (8–58) and surgical mortality 14% (4 patients), with 7% in the first 30 days. Median overall survival was 22,3 months. Our results are in line with published data in the literature. Besides surgical morbidity and mortality, Salvage Esophagectomy remains de only chance of cure for patients with locoregional recurrence after radical exclusive CRT. All authors have declared no conflicts of interest.
               
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