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Salvage esophagectomy after exclusive radical chemoradiotherapy: results of the abdominopelvic surgery department in the National Cancer Institute

OBJECTIVE: To present the experience and the results from the Abdominopelvic Surgery Section from the National Cancer Institute in the rescue esophagectomy in patients previously submitted to the exclusive chemoradiotherapy as primary treatment. METHOD: 14 patients submitted to the esophagectomy of rescue from March of 1999 to May of 2006 were analyzed retrospectively. RESULTS: The median age was of 63 years (39-72 years). Eight patients were females and six were males. Nine patients presented the tumor in the medium esophagus and five patients presented the disease in the distal esophagus; epidermoid carcinoma occurred in 12 patients and adenocarcinoma in two patients. The median of the surgical time was of 305 minutes (240-430 minutes). Operation with complete resection (R0) of the tumor was performed in 13 patients and one had metastati cresidual disease to lung apices. Total morbidity was of 69.2 % and there was no operative mortality. All patients were discharged. CONCLUSION: The esophagectomy of rescue was shown to be technically viable; however, it presents a high operative morbidity. It represents the best treatment option for the cure of recurrent tumor, or persistent tumor after exclusive radical chemoradiotherapy. All therapies are considered palliatives, with disappointing survival results.

Esophagectomy; Esophageal neoplasms; Combined modality therapy; Chemotherapy; Radiotherapy; Health Facilities


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