title: Comparison of Salvage Total Pharyngolaryngectomy and Cervical Esophagectomy Between Hypopharyngeal Cancer and Cervical Esophageal Cancer.
abstract: BACKGROUND
  Total pharyngolaryngectomy and cervical esophagectomy (TPLCE) after chemoradiotherapy remains a challenge because of the high rate of complications and few available data on outcomes and safety. The purpose of this study was to evaluate the clinical significance of salvage TPLCE and to compare treatment outcomes between hypopharyngeal cancer and cervical esophageal cancer.
  
  
  METHODS
  Data from 37 consecutive patients who were diagnosed with potentially resectable hypopharyngeal and cervical esophageal cancer after chemoradiotherapy were retrospectively analyzed. The survival and surgical outcomes were investigated between the hypopharyngeal cancer and cervical esophageal cancer groups.
  
  
  RESULTS
  Twenty-six patients were included in hypopharyngeal cancer group and 11 patients were included in cervical esophageal cancer group. The baseline characteristics were balanced between the two groups. Compared to the hypopharyngeal cancer group, the cervical esophageal cancer group had significantly more frequent tracheal-related complications (p < 0.05) and stronger association of distal margin of the cervical esophagus and radiation field with tracheal ischemia after salvage surgery.
  
  
  CONCLUSIONS
  Salvage TPLCE can offer the exclusive chance of prolonged survival. Association of tracheal ischemia with salvage TPLCE was seen more frequently for cervical esophageal cancer. Therefore, the indication for salvage TPLCE must be carefully considered to maintain the balance between curability and safety.
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.|Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takebayashi
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan. t.kamijo@scchr.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kamijo
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagaoka
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitani
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Niihara
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Booka
authors.affiliation: Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Shimada
authors.affiliation: Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy*; D007511:Ischemia / Q000209:etiology*; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018365:Neoplasm, Residual; D010611:Pharyngectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects; D015996:Survival Rate; D014132:Trachea / Q000098:blood supply*; D014133:Tracheal Diseases / Q000209:etiology; D016896:Treatment Outcome