title: [Salvage surgery in esophageal cancer : Feasibility in patients after definitive radiochemotherapy (> 50 Gy)].
abstract: BACKGROUND
  Salvage surgery as an additional therapy option is currently discussed for an increasing number of patients with esophageal cancer after definitive radio(chemo)therapy after tumor progression, recurrence or on explicit request of the patient.
  
  
  OBJECTIVE
  The objective of this study was an analysis of the surgical option of salvage esophagectomy after definitive radiation in patients with esophageal cancer. Additionally the current literature on this topic was evaluated.
  
  
  METHODS
  A total of 92 patients with esophageal cancer from a prospective database were included in this study who underwent esophagectomy either after neoadjuvant radio(chemo)therapy (< 50 Gy) or definitive radio(chemo)therapy (> 50 Gy) between 2002 and 2012. The analysis was performed retrospectively.
  
  
  RESULTS
  The median survival of the two groups of patients was not significantly different after initial diagnosis with 24.2 months (95 % CI 0.0-51.93) for patients undergoing definitive radio(chemo)therapy and 30.7 months (95 % CI 9.3-52.2) for patients after neoadjuvant therapy (p = 0.96). Both patient groups showed no differences in pretherapeutic characteristics and response to radio(chemo)therapy. Postoperative complications and perioperative mortality were not different.
  
  
  CONCLUSIONS
  Salvage esophagectomy is now an additional treatment option after definitive radio(chemo)therapy in patients with esophageal cancer. In preselected patients with tumor recurrence, progression or with a strong wish for surgical therapy, salvage surgery should be discussed in interdisciplinary tumor boards after exclusion of distant metastases.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Schmidt
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Sisic
authors.affiliation: Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Sterzing
authors.affiliation: Department of Medical Oncology, National Center of Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: G-M
authors.initials: GM
authors.lastname: Haag
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Kunzmann
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Grenacher
authors.affiliation: Department of Pathology, University of Heidelberg, Heidelberg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Weichert
authors.affiliation: Department of Medical Oncology, National Center of Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Jäger
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland.
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Deutschland. katja.ott@ro-med.de.|Department of General, Vascular and Thoracic Surgery, Klinik für Allgemein-, Gefäß- und Thoraxchirurgie, RoMed Klinikum Rosenheim, Pettenkoferstr. 10, 83022, Rosenheim, Deutschland. katja.ott@ro-med.de.
authors.forename: K
authors.initials: K
authors.lastname: Ott
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D059248:Chemoradiotherapy; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D015996:Survival Rate
keywords: Definitive radiochemotherapy; Esophageal cancer; Neoadjuvant radiochemotherapy; Prognosis; Salvage surgery