Radical resection or chemoradiotherapy for cervical esophageal cancer?
BACKGROUND
The prognosis and quality of life (QOL) for those with cervical esophageal cancer is extremely poor, and chemoradiotherapy remains the mainstay treatment. During the past few years, our surgical teams has implemented a more aggressive and radical resection: total laryngopharyngectomy with neck dissection, total esophagectomy, and reconstruction with stomach. This study compares the results of chemoradiotherapy and that of the aforementioned surgical approach.


METHODS
This is a retrospective study of 15 patients who underwent radical resection and 14 patients who received chemoradiation. Their age, sex, tumor stage and grade, pre- and posttreatment dysphagia scores, operating time, blood loss, length of intensive care and postoperative stay, days to resume oral intake, complications, Eastern Cooperative Oncology Group (ECOG) status, QOL score, and disease-specific survival were recorded and compared.


RESULTS
There were no significant differences in age, sex, pretreatment dysphagia score, cancer stage and grade, ECOG status (posttreatment), associate diseases, preoperative QOL, or follow-up period between the two groups. However, the posttreatment dysphagia score was significantly better for the operative group (P < 0.001). QOL improved in both groups, and the operative group seemed better although the difference was not significant. In addition, the survival between the two groups was statistically insignificant (P = 0.97, log-rank test).


CONCLUSIONS
Our experience showed that radical surgery that includes total laryngopharyngectomy with neck dissection, total esophagectomy, and reconstruction with stomach for cervical esophageal cancer is beneficial to patients in terms of better eating.
Chou
Shah-Hwa
SH
Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC. shhwch@kmu.edu.tw
Li
Hsien-Pin
HP
Lee
Jui-Ying
JY
Huang
Meei-Feng
MF
Lee
Chia-Hua
CH
Lee
Ka-Wo
KW
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013270:Stomach / Q000637:transplantation; D013908:Thoracotomy; D014139:Tracheostomy; D016896:Treatment Outcome