TY - CHAP M1 - Book, Section TI - Salvage Esophagectomy for Locally Recurrent or Persistent Esophageal Carcinoma A1 - Groth, Shawn S. A1 - Li, Zhigang A1 - Rice, Thomas W. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - Multimodal therapy for locally advanced esophageal carcinoma offers the highest probability of long-term overall and disease-free survival. However, the optimal multimodal treatment strategy is controversial. Morbidity rates after esophagectomy are high (30–60%) and mortality rates can exceed 20% in lower volume centers.1–3 Furthermore, with clinical trial data demonstrating pathologic complete response rates of 23–49% (depending on histology) after neoadjuvant chemoradiation4–6 and some studies demonstrating no survival advantage of esophagectomy as part of a multimodal treatment strategy over chemoradiation alone,7,8 many physiologically fit patients are treated with definitive chemoradiation therapy. However, even this strategy is far from optimal as chemoradiation therapy trials for locally advanced esophageal carcinoma have reported locoregional recurrence or progression rates of 25–60%.9–11 Treatment of recurrent or persistent esophageal cancer after primary therapy is typically palliative and most commonly nonsurgical. However, in rare situations, salvage esophagectomy has been reported to be useful in carefully selected patients in a final attempt to cure. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/23 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170406845 ER -