| International Session（Symposium）7(JSGS・JSGE・JGES・JSH) |
| Sat. November 7th 15:00 - 17:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Application of thoracoscopic esophagectomy for esophageal cancer invading to adjacent organs | |||
| Itasu Ninomiya1, Koichi Okamoto1, Sachio Fushida1 | |||
| 1Department of Gastroenterological Surgery, Kanazawa University | |||
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| Introduction: The prognosis of T4b esophageal cancer invading to adjacent organs is quite unfavorable. No promising therapeutic strategy has been established for T4b esophageal cancer until today. Recently, we applied thoracoscopic esophagectomy (TE) as conversion surgery in combination with induction chemotherapy for T4b esophageal cancer. Methods: We performed TE in the left lateral position for T4b esophageal cancer when remission of the tumor was confirmed by preoperative induction chemotherapy. We tried to perform R0 or R1 resection under the magnifying effect of the video scope. Results: From 2003 to 2019, we experienced 43 TE for T4b esophageal cancer patients. Among them, 34 patients underwent induction chemotherapy before TE. Curative resection could be possible in 18 (52.9%) of 34 patients underwent induction chemotherapy. No curative resection can be performed in 9 patients without chemotherapy. Conversion to thoracotomy was performed in 1 patient for bronchial injury. We experienced no operative mortality. Both relapse-free and overall survival analysis showed the patient underwent curative TE showed significantly favorable prognosis in comparison to those with non-curative resection (P=0.001 and P<0.001, respectively). The overall 5-year survival rate after curative and non-curative TE was 64.7% and 10.3%, respectively. Conclusion: TE can be performed safely as a conversion surgery after induction chemotherapy for T4b esophageal cancer. Therapeutic effect of induction chemotherapy and meticulous dissection by TE may contribute favorable survival of T4b esophageal cancer patients. |
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Index Term 1: Esophageal cancer Index Term 2: Thoracoscopic esophagectomy |
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