International Session（Symposium）2(JSGS・JSGE・JGES)
Fri. November 3rd   14:00 - 17:00   Room 11: Portopia Hotel South Wing Topaz
IS-S2-2_S
 Evidence and Experiences of Conversion Surgery for Thoracic Esophageal Cancer
Hiroshi Sato1, Yutaka Miyawaki1, Seigi Lee1
1Department of Gastroenterological Surgery, Saitama Medical University International Medical Center
Introduction: Radical chemoradiotherapy (dCRT) is an important treatment option for thoracic esophageal cancer. In this study, we investigated the technique, prognosis, and postoperative complications of conversion surgery after dCRT, with the aim of gaining knowledge to achieve both cure and safety.
Methods:The study included 38 patients who underwent salvage surgery after dCRT for thoracic esophageal cancer suspected of invasion of other organs. The median age was 68 years (38-80 years). cT4b invasive organs were trachea and left main bronchus in 22 cases, aorta in 12 cases, and other organs in 4 cases. Results, complications, and recurrence were retrospectively reviewed. We also reviewed two recent cases after the use of immunocheckpoint inhibitors (ICIs).
Results: One patient died in the hospital (2.6%). Postoperative complications (Clavien-Dindo Grade II or higher) were observed in 17 patients (45%), including pneumonia in 9 patients (24%). The median recurrence-free survival was 15 months. 7 patients (18%) showed histopathological evidence of cancer remnants, and the prognosis was poor in patients with remnant disease, aortic invasion, or preoperative lymph node metastasis. 2 patients underwent radical resection without complications after the use of ICI.
Conclusions:Perioperative outcomes are acceptable. Down staging is more likely to be achieved after radical chemoradiotherapy. The prognosis of patients with aortic invasion or lymph node metastasis is poor. Surgical outcomes after ICI use need to be accumulated.
Index Term 1: Thoracic esophageal Cancer
Index Term 2: Conversion surgery
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