Surgical Outcomes for Cervical Esophageal Cancer: A Retrospective Cohort Study

Area of Science:

• Oncology
• Surgical Oncology
• Esophageal Cancer Research

Background:

• Definitive chemoradiotherapy (dCRT) is standard for cervical esophageal cancer (CEC).
• Conflicting surgical outcome data necessitates further investigation into surgical treatment for CEC.

Purpose of the Study:

• To compare surgical outcomes between laryngeal-preserving esophagectomy (LP) and total pharyngo-laryngo-esophagectomy (TPLE) for CEC.
• To evaluate the impact of surgical approach on survival and perioperative safety in CEC patients.

Main Methods:

• Retrospective review of 152 CEC patients undergoing surgery (May 2014-May 2024).
• Stratification by surgical procedure: LP vs. TPLE.
• Analysis of baseline data, perioperative outcomes, Kaplan-Meier survival, and multivariable Cox regression.

Main Results:

• LP (85 patients) showed a higher 2-year overall survival (OS) rate (71.2%) than TPLE (67 patients) (43.5%, p=0.035).
• TPLE had a higher R0 resection rate (89.6% vs. 75.3%, p=0.024) but significantly higher noncancer-related mortality (16.4% vs. 4.7%, p<0.001) and 90-day mortality (7.5% vs. 0%, p=0.010).
• TPLE was identified as an independent risk factor for OS (HR 1.872, p=0.021).

Conclusions:

• Surgical treatment for CEC, particularly LP, demonstrates promising survival outcomes compared to historical dCRT data.
• Despite a lower R0 resection rate, LP offers superior survival rates and enhanced perioperative safety over TPLE for CEC.
• LP represents a potentially safer and more effective surgical option for select CEC patients.