RT Book, Section
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
SR Print(0)
ID 1170406845
T1 Salvage Esophagectomy for Locally Recurrent or Persistent Esophageal Carcinoma
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170406845
RD 2024/04/19
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.