Treatment of local recurrence of esophageal cancer following Ivor‐Lewis esophagectomy—Experiences of a high‐volume center

Author:

Knipper Karl1ORCID,Krey Thaddaeus1,Lyu Su Ir2,Jung Jin‐On1,Wirsik Naita M.1,Fuchs Hans F.1,Schröder Wolfgang1,Schlößer Hans A.13,Popp Felix C.1,Quaas Alexander2,Bruns Christiane J.1,Schmidt Thomas1

Affiliation:

1. Faculty of Medicine and University Hospital of Cologne Department of General Visceral and Cancer Surgery University of Cologne Cologne Germany

2. Faculty of Medicine and University Hospital of Cologne Institute of Pathology University of Cologne Cologne Germany

3. Faculty of Medicine and University Hospital of Cologne Center for Molecular Medicine Cologne University of Cologne Cologne Germany

Abstract

AbstractPurposePatients with local recurrence of esophageal cancer have a highly decreased overall survival. There is currently no standardized treatment algorithm for this group. This retrospective cohort study aimed to evaluate the survival of patients with local recurrence, despite receiving individualized treatment options.Methods241 of 1791 patients were diagnosed with a local recurrence following Ivor‐Lewis esophagectomy at the University Hospital of Cologne. 59 patients, who were diagnosed only with a local recurrence of adeno‐ or squamous cell carcinoma and received their individualized therapy regimes at our high‐volume center, were included.ResultsThe study included 52 patients with adenocarcinoma and 7 with squamous cell carcinoma. Among these, 6 patients underwent resection, 19 received solely chemotherapy, 29 received chemoradiotherapy, and 5 were provided with best supportive care. Patients who underwent resection showed a better survival outcome compared to patients without resection (median OS: not reached vs. 15.1 months, p = 0.012). Best supportive care and palliative care were found to be independent risk factors for shorter overall survival compared to curative intended treatment options like local resection or chemoradiotherapy.ConclusionIn this study, different treatment strategies for patients with local recurrence of esophageal cancer were depicted. Resection as well as chemoradiotherapy could play a role in selected patients. Further prospective studies are needed to improve the selection of eligible patients.

Funder

Universität zu Köln

Publisher

Wiley

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