Surgical Outcomes for Cervical Esophageal Cancer: A Retrospective Cohort Study.

Abstract

Although definitive chemoradiotherapy (dCRT) remains the standard for cervical esophageal cancer (CEC), studies on surgical outcomes have reported conflicting results. This highlights the need for more data on surgical treatment for CEC. This study reviewed 152 patients who underwent surgical treatment for CEC at a single center between May 2014 and May 2024. Patients were stratified by surgical procedure: laryngeal-preserving esophagectomy (LP) versus. total pharyngo-laryngo-esophagectomy (TPLE). Baseline data and perioperative outcomes were analyzed. Kaplan-Meier analysis and multivariable Cox regression were performed. Eighty-five patients underwent LP whereas 67 patients underwent TPLE. The median follow-up time was 24 months. Overall survival (OS) rate at 2-year for all patients was 58.9%, and a higher 2-year OS rate (71.2% vs. 43.5% and p = 0.035) was observed in the LP group compared to the TPLE group. The TPLE group had a higher R0 resection (negative resection margin) rate (75.3% vs. 89.6% and p = 0.024) but higher incidence of noncancer-related mortality (16.4% vs. 4.7% and p < 0.001) and 90-day mortality (7.5% vs. 0% and p = 0.010) compared to the LP group. Multivariable Cox regression analysis demonstrated that TPLE as an independent risk factor for OS (hazard ratio (HR), 1.872; 95% confidence interval [CI], 1.101-3.184; and p = 0.021). The survival outcomes of surgical treatment for CEC showed promising when compared to historical data of definitive chemoradiotherapy. Although the LP group had a lower R0 resection rate than the TPLE group, it demonstrated better survival rates and perioperative safety.