Surgical management of carcinoma of the cervical esophagus.
OBJECTIVE
The aim of the present study was to clarify the clinicopathological characteristics, reconstruction methods after resection, and prognosis of cervical esophageal squamous cell carcinoma.


METHODS
Seventy-four with squamous cell carcinomas of the cervical esophagus not previously treated who underwent cervical esophagectomy or total esophagectomy with or without laryngectomy were retrospectively analyzed.


RESULTS
The operative morbidity and in-hospital mortality rates were 34% (25 patients) and 4% (3 patients), respectively. Alimentary continuity was achieved with free jejunal transfer (50 patients), gastric pull-up (19 patients), and other procedures (5 patients). The frequencies of postoperative complications and death did not differ between free jejunal transfer and gastric pull-up. The overall 3- and 5-year survival rates were 42% and 33%, respectively. The significant clinicopathological factors affecting survival were patient gender, high T factor, lymph node involvement, palpable cervical lymph nodes, vocal cord paralysis, lymphatic invasion, and extracapsular invasion. The pattern of first failure was most often locoregional (82%, 36 patients).


CONCLUSIONS
The choice of free jejunal transfer or gastric pull-up for reconstruction after surgical resection of cervical esophageal carcinoma depends on the degree of tumor extension. Adverse factors affecting survival should be considered when candidates for the surgery are selected.
Daiko
Hiroyuki
H
Department of Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. hdaikou@east.ncc.go.jp
Hayashi
Ryuichi
R
Saikawa
Masahisa
M
Sakuraba
Minoru
M
Yamazaki
Mitsuo
M
Miyazaki
Masakazu
M
Ugumori
Toru
T
Asai
Masahiro
M
Oyama
Waichiro
W
Ebihara
Satoshi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality; D004944:Esophagoplasty / Q000379:methods* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D007825:Laryngectomy; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery; D015996:Survival Rate
D002945:Cisplatin