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Updated: Apr 28, 2026
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
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Salvage esophagectomy.
1Department of Thoracic and Cardiovascular Surgery, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
Journal of Thoracic Disease
|May 31, 2014
Summary
For esophageal cancer patients treated with definitive chemoradiation (dCXRT), salvage esophagectomy is a viable option for local recurrence. Early referral to experienced centers improves outcomes for persistent or recurrent disease after dCXRT.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Definitive chemoradiation (dCXRT) is a primary treatment for locally advanced esophageal cancer.
- Patients may receive dCXRT due to surgical ineligibility, patient preference, or performance status decline.
- Local/regional recurrence after dCXRT presents significant challenges with limited therapeutic options.
Purpose of the Study:
- To review current literature on the relevance of salvage esophagectomy for esophageal cancer.
- To evaluate salvage resection as a treatment option for local/regional recurrence post-dCXRT.
- To advocate for surgical consultation in select cases of persistent or recurrent disease.
Main Methods:
- Literature review of recent studies on salvage esophagectomy.
- Analysis of outcomes for patients with local/regional recurrence after dCXRT.
- Discussion of the historical perception versus current evidence for salvage resection.
Main Results:
- Salvage esophagectomy, historically viewed as high-risk, is increasingly recognized as a relevant option.
- Recent literature suggests improved outcomes and feasibility for salvage resection in experienced centers.
- Persistent or recurrent local/regional disease after dCXRT warrants consideration for surgical intervention.
Conclusions:
- Salvage esophagectomy should be reconsidered as a treatment for local/regional recurrence after dCXRT.
- Patients with persistent or recurrent disease after dCXRT should be referred to specialized esophageal centers.
- Experienced surgical centers can offer viable options for patients facing recurrence post-dCXRT.
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