Hofstetter Wayne L
Department of Thoracic and Cardiovascular Surgery, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
J Thorac Dis. 2014 May;6 Suppl 3(Suppl 3):S341-9. doi: 10.3978/j.issn.2072-1439.2014.03.29.
Patients with locally advanced esophageal cancer are treated with definitive chemoradiation (dCXRT) for a number of reasons. Some patients are never referred to a surgeon for a con-versation about surgery, others decline surgery, and some are not candidates for surgery due to a sag in performance status secondary to therapy. Regardless of method of arrival at dCXRT, the risk of local/regional recurrence during follow-up is significant. Many of these patients are faced with limited options for therapy once dCXRT has failed. Salvage esoph-agectomy has historically been considered a morbid procedure and poor choice for lo-cal/regional recurrence. This chapter reviews the recent literature arguing the relevance of salvage resection. We recommend that any patient suffering from persistent or recurrent lo-cal/regional only disease after dCXRT should be referred to an experienced esophageal center to consider surgical options.
局部晚期食管癌患者接受根治性放化疗（dCXRT）有多种原因。一些患者从未被转介给外科医生讨论手术事宜，另一些患者拒绝手术，还有一些患者由于治疗后身体状况下降而不适合手术。无论采用何种方式接受dCXRT，随访期间局部/区域复发的风险都很高。一旦dCXRT失败，这些患者中的许多人面临的治疗选择有限。挽救性食管切除术历来被认为是一种创伤性大的手术，对于局部/区域复发来说不是一个好的选择。本章回顾了近期关于挽救性切除相关性的文献。我们建议，任何在dCXRT后仅患有持续性或复发性局部/区域疾病的患者，都应被转介至经验丰富的食管疾病中心，以考虑手术选择。
