Outcomes of esophagectomy for patients with esophageal squamous cell carcinoma accompanied by recurrent laryngeal nerve palsy at diagnosis.
Esophageal cancer
Esophagectomy
Hoarseness
Recurrent laryngeal nerve
Journal
Esophagus : official journal of the Japan Esophageal Society
ISSN: 1612-9067
Titre abrégé: Esophagus
Pays: Japan
ID NLM: 101206627
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
21
01
2021
accepted:
06
10
2021
pubmed:
28
10
2021
medline:
29
3
2022
entrez:
27
10
2021
Statut:
ppublish
Résumé
Hoarseness is one of the classical symptoms in patients with locally advanced thoracic esophageal squamous cell carcinoma (ESCC), and it results from recurrent laryngeal nerve palsy, which is caused by nodal metastasis along the recurrent laryngeal nerve or by main tumors. We reviewed the short-term and long-term results of esophagectomy for patients with locally advanced ESCC and hoarseness at diagnosis. Patients who initially presented with hoarseness from recurrent laryngeal nerve palsy between 2009 and 2018 and underwent esophagectomy for thoracic ESCC were eligible for this study. Pharyngolaryngectomy or cervical ESCC were exclusionary. A total of 15 patients were eligible, and 14 underwent resection of the recurrent laryngeal nerves. The remaining patient had nerve-sparing surgery. Nine patients (60%) had post-operative complications ≥ Clavien-Dindo class II and, pulmonary complications were most common. Two patients (13%) died in the hospital. The 5-year overall survival rate for all patients was 16%. Age (≤ 65 years), cT1/T2 tumor, and remarkably good response to neoadjuvant treatment were likely related to longer survival; however, these relationships were not statistically significant. Esophagectomy for ESCC patients who are diagnosed with recurrent laryngeal nerve paralysis at initial presentation could be a treatment option if the patient is relatively young, has a cT1/T2 tumor, or shows a remarkably good response to neoadjuvant treatment. However, clinicians should be aware of the possibility of postoperative pulmonary complications, which were frequently observed with the procedure.
Sections du résumé
BACKGROUND
Hoarseness is one of the classical symptoms in patients with locally advanced thoracic esophageal squamous cell carcinoma (ESCC), and it results from recurrent laryngeal nerve palsy, which is caused by nodal metastasis along the recurrent laryngeal nerve or by main tumors. We reviewed the short-term and long-term results of esophagectomy for patients with locally advanced ESCC and hoarseness at diagnosis.
PATIENTS
Patients who initially presented with hoarseness from recurrent laryngeal nerve palsy between 2009 and 2018 and underwent esophagectomy for thoracic ESCC were eligible for this study. Pharyngolaryngectomy or cervical ESCC were exclusionary.
RESULTS
A total of 15 patients were eligible, and 14 underwent resection of the recurrent laryngeal nerves. The remaining patient had nerve-sparing surgery. Nine patients (60%) had post-operative complications ≥ Clavien-Dindo class II and, pulmonary complications were most common. Two patients (13%) died in the hospital. The 5-year overall survival rate for all patients was 16%. Age (≤ 65 years), cT1/T2 tumor, and remarkably good response to neoadjuvant treatment were likely related to longer survival; however, these relationships were not statistically significant.
CONCLUSIONS
Esophagectomy for ESCC patients who are diagnosed with recurrent laryngeal nerve paralysis at initial presentation could be a treatment option if the patient is relatively young, has a cT1/T2 tumor, or shows a remarkably good response to neoadjuvant treatment. However, clinicians should be aware of the possibility of postoperative pulmonary complications, which were frequently observed with the procedure.
Identifiants
pubmed: 34705146
doi: 10.1007/s10388-021-00890-6
pii: 10.1007/s10388-021-00890-6
pmc: PMC8921150
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
233-239Informations de copyright
© 2021. The Author(s).
Références
Ann Thorac Surg. 2005 Jun;79(6):1886-9
pubmed: 15919278
J Clin Oncol. 1999 Sep;17(9):2915-21
pubmed: 10561371
J Surg Oncol. 1995 Aug;59(4):230-2
pubmed: 7630169
Ann Thorac Cardiovasc Surg. 2001 Dec;7(6):325-9
pubmed: 11888470
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
J Surg Oncol. 2012 Nov;106(6):742-7
pubmed: 22504922
World J Surg. 2007 Nov;31(11):2192-8
pubmed: 17874334
J Clin Pathol. 2016 Nov;69(11):956-961
pubmed: 27387986
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593