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

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• 作者：Satoshi Ida MD ; PhD (1) (3)
  Masaru Morita MD ; PhD ; FACS (1)
  Yukiharu Hiyoshi MD ; PhD (1) (3)
  Keisuke Ikeda MD (1)
  Koji Ando MD ; PhD (1)
  Yasue Kimura MD ; PhD (1)
  Hiroshi Saeki MD ; PhD (1)
  Eiji Oki MD ; PhD (1)
  Tetsuya Kusumoto MD ; PhD (1)
  Sei Yoshida MD ; PhD (2)
  Torahiko Nakashima MD ; PhD (2)
  Masayuki Watanabe MD ; PhD ; FACS (3)
  Hideo Baba MD ; PhD ; FACS (3)
  Yoshihiko Maehara MD ; PhD ; FACS (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：21
• 期：4
• 页码：1175-1181
• 全文大小：407 KB
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• 作者单位：Satoshi Ida MD, PhD (1) (3)
  Masaru Morita MD, PhD, FACS (1)
  Yukiharu Hiyoshi MD, PhD (1) (3)
  Keisuke Ikeda MD (1)
  Koji Ando MD, PhD (1)
  Yasue Kimura MD, PhD (1)
  Hiroshi Saeki MD, PhD (1)
  Eiji Oki MD, PhD (1)
  Tetsuya Kusumoto MD, PhD (1)
  Sei Yoshida MD, PhD (2)
  Torahiko Nakashima MD, PhD (2)
  Masayuki Watanabe MD, PhD, FACS (3)
  Hideo Baba MD, PhD, FACS (3)
  Yoshihiko Maehara MD, PhD, FACS (1)
  
  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  3. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
  2. Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  
• ISSN：1534-4681

文摘

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.