caa a22 4500 445889284 CHVBK 20180317145610.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s00535-011-0448-0 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0448-0 Clinical significance of salvage esophagectomy for remnant or recurrent cancer following definitive chemoradiotherapy [Elektronische Daten] [Masaru Morita, Ryuichi Kumashiro, Yuichi Hisamatsu, Ryota Nakanishi, Akinori Egashira, Hiroshi Saeki, Eiji Oki, Takefumi Ohga, Yoshihiro Kakeji, Shunichi Tsujitani, Takeharu Yamanaka, Yoshihiko Maehara] Background: The purpose of this study was to clarify the effect of preoperative chemoradiotherapy (CRT) for esophageal cancer on the postoperative course, and to determine the clinical significance of salvage esophagectomy after definitive CRT. Methods: Based on their preoperative treatment, 477 patients with esophageal cancer were classified into three groups: 253 patients who received surgery alone (Group I), 197 who received planned CRT (30-45Gy, Group II), and 27 who received a salvage esophagectomy (radiation ≥60Gy, Group III). Results: Postoperative complications developed in 25, 40, and 59% of the patients in Groups I, II, and III, respectively, with pulmonary complications developing in 10, 15, and 30%, and anastomotic leakage developing in 13, 23, and 37%, respectively. Mortality rates were 2.4, 2.0, and 7.4%, respectively. Multivariate analysis revealed preoperative therapy to be an independent factor associated with postoperative risks: the odds ratios (ORs) of Groups II and III compared to Group I were 1.8 and 4.0 for pulmonary complications, while they were 1.9 and 2.8, respectively, for anastomotic leakage. No critical complications developed in the 14 patients who received salvage surgery performed with strict surgical indications after 2005. The survival of Group III was not significantly different from that of Groups I and II. Most patients who received an R1/R2 resection after definitive CRT died within 2years after salvage surgery. Conclusions: Preoperative CRT is associated with postoperative complications especially in patients with R2 resection, while long-term survival can be achieved after R0 resections. Salvage surgery should be considered for carefully selected patients in whom R0 resection can be achieved. Springer, 2011 Esophageal cancer nationallicence Salvage esophagectomy nationallicence Definitive chemoradiotherapy nationallicence Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Kumashiro Ryuichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Hisamatsu Yuichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Nakanishi Ryota Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Egashira Akinori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Oki Eiji Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Ohga Takefumi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Tsujitani Shunichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Yamanaka Takeharu Cancer Biostatistics Laboratory, Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan aut Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut Journal of Gastroenterology Springer Japan 46/11(2011-11-01), 1284-1291 0944-1174 46:11<1284 2011 46 535 https://doi.org/10.1007/s00535-011-0448-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0448-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kumashiro Ryuichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Hisamatsu Yuichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Nakanishi Ryota Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Egashira Akinori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Oki Eiji Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ohga Takefumi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Tsujitani Shunichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 700 1- Yamanaka Takeharu Cancer Biostatistics Laboratory, Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan aut NATIONALLICENCE 700 1- Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812- 8582, Fukuoka, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/11(2011-11-01), 1284-1291 0944-1174 46:11<1284 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer