Surgical Outcomes of Cervical Esophageal Cancer: A Single-Center Experience

• Published in: Journal of chest surgery Vol. 57; no. 1; pp. 62 - 69
• Main Authors: Lee, Yoonseo, Yun, Jeonghee, Jeon, Yeong Jeong, Lee, Junghee, Park, Seong Yong, Cho, Jong Ho, Kim, Hong Kwan, Choi, Yong Soo, Shim, Young Mog
• Format: Journal Article
• Language: English
• Published: The Korean Society for Thoracic and Cardiovascular Surgery 05-01-2024; Korean Society for Thoracic & Cardiovascular Surgery; 대한심장혈관흉부외과학회
• Subjects: cervical esophageal cancer; Clinical Research; free jejunal graft; gastric pull-up; 흉부외과학
• ISSN: 2765-1606; 2765-1614
• DOI: 10.5090/jcs.23.085

Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.