A reappraisal of surgical management for squamous cell carcinoma in the pharyngoesophageal junction

Hao Wei Wang, Pen Yuan Chu, Kuang Tai Kuo, Chia Hsin Yang, Shyue Yih Chang, Wen Hu Hsu, Liang Shun Wang

研究成果: 雜誌貢獻文章同行評審

46 引文 斯高帕斯(Scopus)

摘要

Background: Squamous cell carcinoma (SCC) in the pharyngoesophageal junction (PEJ) with concomitant involvement of both the hypopharynx and cervical esophagus occurs rarely and poses a challenge in treatment. Data regarding the long-term result of aggressive surgical management was lacking. Methods: Forty-one consecutive patients were treated with total pharyngolaryngo- esophagectomy (PLE) and reconstruction between 1984 and 2002. The clinicopathological parameters and prognostic data were analyzed. Results: The surgery carried a postoperative mortality rate of 9.8%. The overall median survival was 18.5 months, with a 31.5% 5-year survival rate. By multivariate analysis, patients with major tumor localization in the hypopharynx had significantly favorable prognosis (median survivals for hypopharyngeal versus esophageal localization, 37.2 versus 7.1 months, P = 0.043). The administration of adjuvant radiotherapy and tumor size less than 5 cm also contributed to a better outcome (P = 0.001 and P = 0.037, respectively). Conclusions: An aggressive surgical approach with total PLE in conjunction with adjuvant radiotherapy represents a feasible option for treatment of advanced SCC simultaneously involving the hypopharynx and cervical esophagus, given the major tumor localization in the hypopharynx. On the other hand, radical surgery for those with major esophageal localization or with tumor size larger than 5 cm yielded ominous results and warrants further justification.

原文英語
頁(從 - 到)468-476
頁數9
期刊Journal of Surgical Oncology
93
發行號6
DOIs
出版狀態已發佈 - 5月 1 2006
對外發佈

ASJC Scopus subject areas

  • 手術
  • 腫瘤科

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