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

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  • Sune Brinck Erichsen, Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Josefine Slater
  • Birgitte Jul Kiil
  • Torben Ingemann Petersen, Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Niels Katballe
  • Mette Bak Nielsen, Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Arunas Pikelis, Department of Otolaryngology, Institute of Head and Neck Studies and Education, Department of Head and Neck Surgery, University of Birmingham, Birmingham, United Kingdom., Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Marianne Nordsmark
  • Daniel Kjaer, Hospital Pharmacy, Aarhus University Hospital, Aarhus

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 languageEnglish
JournalDiseases of the Esophagus (Online)
ISSN1442-2050
DOIs
Publication statusE-pub ahead of print - 21 Jul 2021

Bibliographical note

© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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