Functional outcome and survival after pharyngolaryngoesophagectomy for cancer

Surgical management of carcinoma of the cervical esophagus

“…However, carcinoma of the cervical esophagus extends easily and frequently upward to the hypopharynx or downward to the thoracic esophagus, and almost all tumors are located at the pharyngocervical or cervicothoracic junctions [2]. For these reasons, carcinomas of the cervical esophagus are classified and reported with carcinomas of the hypopharynx or upper thoracic esophagus [3][4][5][6][7][8][15][16][17][18]. In this study, we attempted to identify the clinicopathological characteristics, methods of reconstruction after resection, and the prognosis of carcinoma of the cervical esophagus.…”

“…Prognostic factors reported by previous studies to influence the long-term survival of patients with hypopharyngeal and cervical esophageal carcinoma include positive surgical margins [8,15], lymph node involvement [8,16], postoperative complications [6,17], patient gender [6,17], depth of tumor invasion [2,6,16], intramural metastasis [6], and tumor size more than 5 cm [18]. However, most of these studies combined results from cases of hypopharyngeal and cervical esophageal carcinoma or from cases treated with chemotherapy or radiotherapy without surgery.…”

Gastrointestinal reconstructions in 1200 patients with cancer at the pharyngesophageal junction

“…Overall, decreased survival was statistically associated with the presence of positive margins, cancer cells penetrating the esophageal wall, positive regional lymph nodes, laryngectomy (P ¼ 0.002), additional thoracotomy (P ¼ 0.004), postoperative complications (P ¼ 0.010), gender (P ¼ 0.031), and tumor size greater than 5 cm (P ¼ 0.037) [31,48,49,54].…”

Results after radical surgical treatment for advanced carcinoma of hypopharynx

“…The definite efficacy of radiotherapy apart from stage T1, has not been proven yet. Cases who receive radiotherapy have a 5 year survival rate of 4-20% with frequent local recurrences [3][4][5][6] whereas with radical surgical interventions especially in whom R0 resection is attained to 25-35% [2,[7][8][9]. Interest in surgical approaches have been raised within recent years due to advances in modern intensive care unit practices and progress,surgical techniques, and in the field of anesthesiology [10].…”

“…Gastric pull up (GP) or colonic interpositions are the most frequently preferred methods for reconstruction. Among these, GP technique is favored as it 1) contains a long vascularized segment, 2) allows to a single and wide anastomosis to be performed over the neck, 3) has low incidence of stricture and fistulisation rates, 4) fast rehabilitation programs permits early feeding and short hospitalization period and 5) allows uneventful radiotherapy postoperatively.…”