De Virgilio Armando, Costantino Andrea, Festa Bianca Maria, Mercante Giuseppe, Franceschini Davide, Franzese Ciro, Scorsetti Marta, Marrari Andrea, Cavina Raffaele, Marano Salvatore, Castoro Carlo, Spriano Giuseppe
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.
Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
Eur Arch Otorhinolaryngol. 2023 Jan;280(1):373-390. doi: 10.1007/s00405-022-07589-z. Epub 2022 Aug 15.
To determine the oncological outcomes of cervical esophageal cancer (CEC) treated primarily with surgery.
A systematic review and meta-analysis was performed according to the PRISMA guidelines.
A total of 868 patients were included from 18 studies. Estimated pooled Overall Survival (OS) rates (95% Confidence Interval, CI) at 1 and 5 years were 74.4% (66.5-83.3), and 26.6% (20.3-34.7), respectively. Larynx non-preserving surgery (n = 229) showed an estimated pooled OS rates (95% CI) at 1 and 5 years of 59.3% (51.5-68.2) and 14.6% (8.8-24.3), respectively. On the other hand, larynx preserving surgery (n = 213) showed an estimated pooled OS rates (95% CI) at 1 and 5 years of 83.6% (78.2-89.4) and 35.1% (24.9-49.6), respectively.
Primary larynx-preserving surgery remains a valuable option for the management of CEC, with similar survival outcomes compared to primary chemoradiotherapy (CRT). On the other hand, larynx non-preserving surgery showed a significantly reduced survival, that may reflect the more advanced T classification of these tumors. Further studies are mandatory to directly compare primary surgery and primary CRT, distinguishing larynx preserving and non-preserving surgery.
确定主要采用手术治疗的颈段食管癌（CEC）的肿瘤学结局。
根据PRISMA指南进行系统评价和荟萃分析。
18项研究共纳入868例患者。1年和5年的估计总生存（OS）率（95%置信区间，CI）分别为74.4%（66.5 - 83.3）和26.6%（20.3 - 34.7）。不保喉手术（n = 229）1年和5年的估计总生存（OS）率（95% CI）分别为59.3%（51.5 - 68.2）和14.6%（8.8 - 24.3）。另一方面，保喉手术（n = 213）1年和5年的估计总生存（OS）率（95% CI）分别为83.6%（78.2 - 89.4）和35.1%（24.9 - 49.6）。
对于颈段食管癌的治疗，保喉手术仍是一种有价值的选择，其生存结局与单纯放化疗（CRT）相似。另一方面，不保喉手术的生存率显著降低，这可能反映了这些肿瘤更高级别的T分期。必须进行进一步研究以直接比较手术和单纯放化疗，并区分保喉手术和不保喉手术。
