Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study

Sune Brinck Erichsen; Josefine Slater; Birgitte Jul Kiil; Torben Ingemann Petersen; Niels Katballe; Mette Bak Nielsen; Arunas Pikelis; Marianne Nordsmark; Daniel Kjaer

doi:10.1093/dote/doab048

Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study

Sune Brinck Erichsen^*, Josefine Slater, Birgitte Jul Kiil, Torben Ingemann Petersen, Niels Katballe, Mette Bak Nielsen, Arunas Pikelis, Marianne Nordsmark, Daniel Kjaer

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: The role of surgery in treatment of locally advanced cervical esophageal cancer (CEC) remains debated. In the European and American treatment guidelines, definitive chemoradiotherapy (dCRT) is preferred over surgery, while in the Danish guidelines, the two treatment modalities are equally recommended. Surgical treatment of CEC is centralized at our center in Denmark. We present our outcomes following neoadjuvant chemoradiotherapy (nCRT) when possible and resection as first-line therapy for CEC and compare with recent published dCRT results.

METHOD: We retrospectively reviewed the medical charts of patients treated for cervical esophageal cancer at Aarhus University Hospital from 2001-2018 with nCRT when possible and pharyngolaryngectomy followed by reconstruction with a free jejunal graft.

RESULTS: Forty consecutive patients were included. About, 45% received nCRT. The median survival was 21 months. The overall, disease-specific and disease-free 5-year survival was 43.6%, 53.2%, and 47.4%, respectively. The rate of microscopically radical resection was 85%. The recurrence rate was 47% and 81% of recurrences were locoregional. The in-hospital and 30-day mortality rate was 0%. Major complications occurred in 27.9%. Anastomotic leakage, graft failure, fistulas and strictures occurred in 10%, 7.5%, 30%, and 30%, respectively.

CONCLUSION: Our treatment offers equal oncological results compared to the best internationally published results for dCRT for CEC. Results vary considerably between dCRT studies. Morbidity appears more pronounced following surgery. Future studies are warranted to investigate the Danish national outcomes following dCRT as first-line treatment for curable locally advanced CEC.

Original language	English
Article number	doab048
Journal	Diseases of the Esophagus (Online)
Volume	35
Issue	3
Number of pages	9
ISSN	1442-2050
DOIs	https://doi.org/10.1093/dote/doab048
Publication status	Published - Mar 2022

Keywords

cervical esophageal cancer
free jejunal graft
morbidity
oncological results
pharyngolaryngectomy
MANAGEMENT
ESOPHAGOGASTRIC JUNCTION
RADIOTHERAPY
CARCINOMA
Esophageal Neoplasms/drug therapy
Humans
Morbidity
Chemoradiotherapy/methods
Denmark/epidemiology
Retrospective Studies
Cohort Studies

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10.1093/dote/doab048

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Erichsen, S. B., Slater, J., Kiil, B. J., Petersen, T. I., Katballe, N., Nielsen, M. B., Pikelis, A., Nordsmark, M., & Kjaer, D. (2022). Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study. Diseases of the Esophagus (Online), 35(3), Article doab048. https://doi.org/10.1093/dote/doab048

@article{84c7163002144c23ae54905a9f813aeb,

title = "Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study",

abstract = "BACKGROUND: The role of surgery in treatment of locally advanced cervical esophageal cancer (CEC) remains debated. In the European and American treatment guidelines, definitive chemoradiotherapy (dCRT) is preferred over surgery, while in the Danish guidelines, the two treatment modalities are equally recommended. Surgical treatment of CEC is centralized at our center in Denmark. We present our outcomes following neoadjuvant chemoradiotherapy (nCRT) when possible and resection as first-line therapy for CEC and compare with recent published dCRT results.METHOD: We retrospectively reviewed the medical charts of patients treated for cervical esophageal cancer at Aarhus University Hospital from 2001-2018 with nCRT when possible and pharyngolaryngectomy followed by reconstruction with a free jejunal graft.RESULTS: Forty consecutive patients were included. About, 45% received nCRT. The median survival was 21 months. The overall, disease-specific and disease-free 5-year survival was 43.6%, 53.2%, and 47.4%, respectively. The rate of microscopically radical resection was 85%. The recurrence rate was 47% and 81% of recurrences were locoregional. The in-hospital and 30-day mortality rate was 0%. Major complications occurred in 27.9%. Anastomotic leakage, graft failure, fistulas and strictures occurred in 10%, 7.5%, 30%, and 30%, respectively.CONCLUSION: Our treatment offers equal oncological results compared to the best internationally published results for dCRT for CEC. Results vary considerably between dCRT studies. Morbidity appears more pronounced following surgery. Future studies are warranted to investigate the Danish national outcomes following dCRT as first-line treatment for curable locally advanced CEC.",

keywords = "cervical esophageal cancer, free jejunal graft, morbidity, oncological results, pharyngolaryngectomy, MANAGEMENT, ESOPHAGOGASTRIC JUNCTION, RADIOTHERAPY, CARCINOMA, Esophageal Neoplasms/drug therapy, Humans, Morbidity, Chemoradiotherapy/methods, Denmark/epidemiology, Retrospective Studies, Cohort Studies",

author = "Erichsen, {Sune Brinck} and Josefine Slater and Kiil, {Birgitte Jul} and Petersen, {Torben Ingemann} and Niels Katballe and Nielsen, {Mette Bak} and Arunas Pikelis and Marianne Nordsmark and Daniel Kjaer",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s).",

year = "2022",

month = mar,

doi = "10.1093/dote/doab048",

language = "English",

volume = "35",

journal = "Diseases of the Esophagus (Online)",

issn = "1442-2050",

publisher = "JohnWiley & Sons, Inc.",

number = "3",

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Erichsen, SB, Slater, J, Kiil, BJ, Petersen, TI, Katballe, N, Nielsen, MB, Pikelis, A, Nordsmark, M & Kjaer, D 2022, 'Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study', Diseases of the Esophagus (Online), vol. 35, no. 3, doab048. https://doi.org/10.1093/dote/doab048

Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study. / Erichsen, Sune Brinck; Slater, Josefine; Kiil, Birgitte Jul et al.
In: Diseases of the Esophagus (Online), Vol. 35, No. 3, doab048, 03.2022.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer

T2 - a retrospective Danish consecutive cohort study

AU - Erichsen, Sune Brinck

AU - Slater, Josefine

AU - Kiil, Birgitte Jul

AU - Petersen, Torben Ingemann

AU - Katballe, Niels

AU - Nielsen, Mette Bak

AU - Pikelis, Arunas

AU - Nordsmark, Marianne

AU - Kjaer, Daniel

PY - 2022/3

Y1 - 2022/3

N2 - BACKGROUND: The role of surgery in treatment of locally advanced cervical esophageal cancer (CEC) remains debated. In the European and American treatment guidelines, definitive chemoradiotherapy (dCRT) is preferred over surgery, while in the Danish guidelines, the two treatment modalities are equally recommended. Surgical treatment of CEC is centralized at our center in Denmark. We present our outcomes following neoadjuvant chemoradiotherapy (nCRT) when possible and resection as first-line therapy for CEC and compare with recent published dCRT results.METHOD: We retrospectively reviewed the medical charts of patients treated for cervical esophageal cancer at Aarhus University Hospital from 2001-2018 with nCRT when possible and pharyngolaryngectomy followed by reconstruction with a free jejunal graft.RESULTS: Forty consecutive patients were included. About, 45% received nCRT. The median survival was 21 months. The overall, disease-specific and disease-free 5-year survival was 43.6%, 53.2%, and 47.4%, respectively. The rate of microscopically radical resection was 85%. The recurrence rate was 47% and 81% of recurrences were locoregional. The in-hospital and 30-day mortality rate was 0%. Major complications occurred in 27.9%. Anastomotic leakage, graft failure, fistulas and strictures occurred in 10%, 7.5%, 30%, and 30%, respectively.CONCLUSION: Our treatment offers equal oncological results compared to the best internationally published results for dCRT for CEC. Results vary considerably between dCRT studies. Morbidity appears more pronounced following surgery. Future studies are warranted to investigate the Danish national outcomes following dCRT as first-line treatment for curable locally advanced CEC.

AB - BACKGROUND: The role of surgery in treatment of locally advanced cervical esophageal cancer (CEC) remains debated. In the European and American treatment guidelines, definitive chemoradiotherapy (dCRT) is preferred over surgery, while in the Danish guidelines, the two treatment modalities are equally recommended. Surgical treatment of CEC is centralized at our center in Denmark. We present our outcomes following neoadjuvant chemoradiotherapy (nCRT) when possible and resection as first-line therapy for CEC and compare with recent published dCRT results.METHOD: We retrospectively reviewed the medical charts of patients treated for cervical esophageal cancer at Aarhus University Hospital from 2001-2018 with nCRT when possible and pharyngolaryngectomy followed by reconstruction with a free jejunal graft.RESULTS: Forty consecutive patients were included. About, 45% received nCRT. The median survival was 21 months. The overall, disease-specific and disease-free 5-year survival was 43.6%, 53.2%, and 47.4%, respectively. The rate of microscopically radical resection was 85%. The recurrence rate was 47% and 81% of recurrences were locoregional. The in-hospital and 30-day mortality rate was 0%. Major complications occurred in 27.9%. Anastomotic leakage, graft failure, fistulas and strictures occurred in 10%, 7.5%, 30%, and 30%, respectively.CONCLUSION: Our treatment offers equal oncological results compared to the best internationally published results for dCRT for CEC. Results vary considerably between dCRT studies. Morbidity appears more pronounced following surgery. Future studies are warranted to investigate the Danish national outcomes following dCRT as first-line treatment for curable locally advanced CEC.

KW - cervical esophageal cancer

KW - free jejunal graft

KW - morbidity

KW - oncological results

KW - pharyngolaryngectomy

KW - MANAGEMENT

KW - ESOPHAGOGASTRIC JUNCTION

KW - RADIOTHERAPY

KW - CARCINOMA

KW - Esophageal Neoplasms/drug therapy

KW - Humans

KW - Morbidity

KW - Chemoradiotherapy/methods

KW - Denmark/epidemiology

KW - Retrospective Studies

KW - Cohort Studies

U2 - 10.1093/dote/doab048

DO - 10.1093/dote/doab048

M3 - Journal article

C2 - 34286828

SN - 1442-2050

VL - 35

JO - Diseases of the Esophagus (Online)

JF - Diseases of the Esophagus (Online)

IS - 3

M1 - doab048

ER -

Oncological results and morbidity following intended curative resection and free jejunal graft reconstruction of cervical esophageal cancer: a retrospective Danish consecutive cohort study

Abstract

Keywords

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