title: Salvage esophagectomy after failure of definitive radiochemotherapy for esophageal cancer.
abstract: BACKGROUND
  Definitive radiochemotherapy (dRCT) in locally advanced esophageal cancer is associated with a high rate of loco-regional recurrence. In this condition, salvage esophagectomy may be considered as a therapeutic option. The aim of this analysis is to evaluate the feasibility and the morbi-mortality of this strategy.
  
  
  METHODS
  Between January 2006 and April 2014, 208 patients underwent esophagectomy for esophageal cancer at ULB-Erasme-Bordet. Thirty-two patients received a preoperative radiochemotherapy (pRCT) followed by planned esophagectomy (Group 1) for locally advanced disease. Sixteen patients underwent salvage esophagectomy for recurrence or failure after dRCT (Group 2). Data on post-operative morbidity and mortality and survival were collected and analyzed.
  
  
  RESULTS
  An increase of overall morbidity was detected in Group 2 as compared to Group 1 (43% vs. 37.5%), mainly related to respiratory complications (35.5% vs. 28%) and anastomotic leak (25% vs. 3%). No 90-days mortality was observed in the two surgical groups. The 1, 2, and 3-year survival rates after surgery were respectively 89%, 80%, and 71% for Group1 and 84%, 73%, and 63% for Group 2.
  
  
  CONCLUSIONS
  In our experience, both salvage esophagectomy and esophagectomy after pRCT showed good survival results with low postoperative morbidity and mortality. Salvage surgery remains a therapeutic indication in selected patients. J. Surg. Oncol. 2016;114:833-837. © 2016 2016 Wiley Periodicals, Inc.
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium. eleonorafarinella@yahoo.it.
authors: Eleonora
authors: E
authors: Farinella
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium.
authors: Adonis
authors: A
authors: Safar
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium.
authors: Haydar A
authors: HA
authors: Nasser
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium.
authors: Fikri
authors: F
authors: Bouazza
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium.
authors: Gabriele
authors: G
authors: Liberale
authors: Data Center, Institut Jules Bordet, Center des Tumeurs ULB Bruxelles, Bruxelles, Belgium.
authors: Marianne
authors: M
authors: Paesmans
authors: Department of Gastroenterology, GI Cancer Unit, ULB-Erasme, Bruxelles, Belgium.
authors: Raphael
authors: R
authors: Marechal
authors: Department of Gastroenterology, GI Cancer Unit, ULB-Erasme, Bruxelles, Belgium.
authors: Jean-Luc
authors: JL
authors: Van Laethem
authors: Department of Medical Oncology, Institut Jules Bordet, Bruxelles, Belgium.
authors: Alain
authors: A
authors: Hendlisz
authors: Department of Radiotherapy, Institut Jules Bordet, Bruxelles, Belgium.
authors: Paul
authors: P
authors: VanHoutte
authors: Department of Digestive Surgery, ULB-Erasme-Bordet, Bruxelles, Belgium.
authors: Issam
authors: I
authors: El Nakadi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: esophageal cancer; esophageal surgery; radiation therapy; salvage esophagectomy