Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
Semin Thorac Cardiovasc Surg. 2013 Summer;25(2):83-6. doi: 10.1053/j.semtcvs.2013.05.003.
Salvage esophagectomy is a rare treatment option in patients failing definitive treatment of esophageal cancer. The ideal patient has recurrent cancer with a long disease-free interval. R0 resection is necessary if long-term survival is to be realized. Patients with small recurrent cancers without M1, T4, or N+ disease are most likely to benefit from salvage esophagectomy. Complications are frequent and are typically pulmonary or anastomotic. Mortality is significant, with 25%-35% survival at most following R0 resection. Most deaths are secondary to cancer or salvage esophagectomy. R1 and R2 resections are to be avoided. Better multimodality treatment planning would eliminate the “nightmare” of salvage esophagectomy.
挽救性食管切除术是食管癌根治性治疗失败后一种罕见的治疗选择。理想的患者是癌症复发且无疾病间期较长。如果要实现长期生存，就必须进行 R0 切除术。最有可能从挽救性食管切除术中获益的是复发肿瘤较小且无 M1、T4 或 N+疾病的患者。并发症常见，通常是肺部或吻合口相关的。死亡率很高，R0 切除术后的生存率最高为 25%-35%。大多数死亡是由癌症或挽救性食管切除术引起的。应避免 R1 和 R2 切除术。更好的多模式治疗计划将消除挽救性食管切除术的“噩梦”。
