International Session(Symposium)2(JSGS・JSGE・JGES)
Fri. November 3rd   14:00 - 17:00   Room 11: Portopia Hotel South Wing Topaz
Conversion and salvage surgery for highly advanced ESCC
Akihiko Okamura1, Kengo Kuriyama1, Masayuki Watanabe1
1Department of Gastroenterological Surgery, Cancer Institute Hospital of JFCR
Background: Surgery after induction therapy (IT) or definitive chemoradiotherapy (dCRT) aiming at cure is one of the effective treatments for initially unresectable locally advanced ESCC.
Patients and methods: Forty-seven cT3br patients who underwent surgery after IT and 36 cT4b patients who underwent salvage surgery for residuals after dCRT were included. We clarified the outcomes and examined the prognosticators.
Results: R0 resection was possible in 89.4% of cT3br patients. 25.5% had severe complications without surgery-related mortality. The 5-year overall survival (5y-OS) rate was 46.9%, and non-R0 resection was an independent poor prognosticator (P < 0.01). Of cT4b patients, 55.6% achieved R0 resection. 22.2% experienced severe complications and surgery-related mortality was 8.3%. The 5y-OS rate was 21.6%, and non-R0 resection and postoperative pneumonia were independent poor prognosticators (both P < 0.01).
Conclusion: In conversion and salvage surgery for initially unresectable locally advanced ESCC, long-term survival can be achieved when R0 resection is performed. Also, postoperative pneumonia prevention is essential.
Index Term 1: ESCC
Index Term 2: Conversion surgery
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