[Salvage esophagectomy after definitive chemoradiation therapy]

Recently, the number of patients undergoing definitive chemoradiotherapy (CRT) for not only incurable esophageal carcinoma, but also resectable tumor has increased. Accordingly, salvage surgery has been conducted for residual or relapsed tumor after definitive CRT. We compared the surgical outcome of 7 cases undergoing salvage esophagectomy (SE) in our hospital, with those of planned CRT( in which 40 Gy external beam was radiated) followed by surgery (PS) and surgery alone (SA). Anastomotic leakage rate of SE (43%) was significantly higher than that of PS (3%) and SA (7%). Respiratory complication rate of SE was higher than that of PS and SA, but not significantly. Hospital mortality rate of SE was 28% and that rate increased in proportion to radiated dose. Salvage surgery should be performed for patients in which complete resection of esophageal cancer could be achieved because of its high rate of mortality and morbidity.