{Reference Type}: Journal Article
{Title}: Esophagectomy for esophageal cancer in patients with a history of total pharyngolaryngectomy: a Japanese nationwide retrospective cohort study.
{Author}: Okamura A;Watanabe M;Okui J;Kuriyama K;Shiraishi O;Kurogochi T;Abe T;Sato H;Miyata H;Kawaguchi Y;Sato Y;Nagano H;Takeno S;Nakajima M;Matsuo K;Murakami K;Takebayashi K;Matsumoto S;Okumura T;Kakeji Y;Kono K;Oridate N;Toh Y;Takeuchi H;Katori Y; ;
{Journal}: Esophagus
{Volume}: 0
{Issue}: 0
{Year}: 2024 Aug 13
{Factor}: 3.671
{DOI}: 10.1007/s10388-024-01078-4
{Abstract}: <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.