%0 Journal Article
%T Esophagectomy for esophageal cancer in patients with a history of total pharyngolaryngectomy: a Japanese nationwide retrospective cohort study.
%A Okamura A
%A Watanabe M
%A Okui J
%A Kuriyama K
%A Shiraishi O
%A Kurogochi T
%A Abe T
%A Sato H
%A Miyata H
%A Kawaguchi Y
%A Sato Y
%A Nagano H
%A Takeno S
%A Nakajima M
%A Matsuo K
%A Murakami K
%A Takebayashi K
%A Matsumoto S
%A Okumura T
%A Kakeji Y
%A Kono K
%A Oridate N
%A Toh Y
%A Takeuchi H
%A Katori Y
%A  
%J Esophagus
%V 0
%N 0
%D 2024 Aug 13
%M 39134901
%F 3.671
%R 10.1007/s10388-024-01078-4
%X <B>BACKGROUND: </B>Second primary esophageal cancer often develops in patients with head and neck cancer, and esophagectomy in patients with a history of total pharyngolaryngectomy (TPL) is challenging. However, the clinical outcomes of these patients have yet to be examined in a multicenter setting.<BR><B>METHODS: </B>We evaluated the surgical outcomes of a nationwide cohort of 62 patients who underwent esophagectomy for esophageal cancer with a history of TPL.<BR><B>RESULTS: </B>Ivor-Lewis and McKeown esophagectomies were performed in 32 (51.6%) and 30 (48.4%) patients, respectively. Postoperatively, 23 patients (37.1%) developed severe complications, and 7 patients (11.3%) required reoperation within 30 days. Pneumonia and anastomotic leakage occurred in 13 (21.0%) and 16 (25.8%) patients, respectively. Anastomotic leakage occurred more frequently in the McKeown group than in the Ivor-Lewis group (46.7% vs. 6.2%, P < 0.001). The adjusted odds ratio for anastomotic leakage in the McKeown group was 9.64 (95% confidence intervals (CI), 2.11-70.82, P = 0.008). Meanwhile, the 5-year overall survival rates were comparable between the groups (41.8% for Ivor-Lewis and 42.7% for McKeown), and the adjusted hazard ratio of overall survival was 1.44 (95% CI, 0.64-3.29; P = 0.381; Ivor-Lewis as the reference).<BR><B>CONCLUSIONS: </B>In our cohort, anastomotic leakage occurred more frequently after McKeown than Ivor-Lewis esophagectomy, and almost half of patients in the McKeown group experienced leakage. Ivor-Lewis esophagectomy is preferred for decreasing anastomotic leakage when oncologically and technically feasible.