Comparison of surgical treatment for cervical esophageal squamous cell carcinoma and upper thoracic esophageal squamous cell carcinoma: A propensity score matching analysis

Wuping Wang; Jie MA; Jipeng Zhang; Tao Wang; Qiang LU; Jinbo Zhao; Xiaolong Yan; Jie Lei; Yunfeng NI; Lijun Huang; Xiaofe LI; Tao Jiang

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Comparison of surgical treatment for cervical esophageal squamous cell carcinoma and upper thoracic esophageal squamous cell carcinoma: A propensity score matching analysis

VernacularTitle:颈段食管鳞癌与胸上段食管鳞癌外科治疗比较的倾向性评分匹配分析
Author: Wuping WANG ^{1
,

2} ; Jie MA ^{1
,

2} ; Jipeng ZHANG ^{1
,

2} ; Tao WANG ^{1
,

2} ; Qiang LU ^{1
,

2} ; Jinbo ZHAO ^{1
,

2} ; Xiaolong YAN ^{1
,

2} ; Jie LEI ^{1
,

2} ; Yunfeng NI ^{1
,

2} ; Lijun HUANG ^{1
,

2} ; Xiaofe LI ^{1
,

2} ; Tao JIANG ^{1
,

2}
Author Information

1. epartment of Thoracic Surgery, Tangdu Hospital, Air Force Military Medical University, Xi'
2. an, 710032, P.R.China
Publication Type:Journal Article
Keywords: Cervical esophageal squamous cell carcinoma; upper thoracic esophageal squamous cell carcinoma; surgery; prognosis; survival
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2021;28(06):701-708
CountryChina
Language:Chinese
Abstract: Objective To evaluate the clinical outcomes of larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical esophageal squamous cell carcinoma (ESCC) without tumor involvement of the larynx and hypopharynx compared with the upper thoracic ESCC. Methods Retrospective and comparative analysis of consecutive patients with cervical and upper thoracic ESCC who underwent R0 surgical resection from 2006 to 2011 in our center was performed. Kaplan-Meier method was used to calculate the patients’ survival. Results In total, 44 pairs of patients, including 71 males and 17 females with an average age of 60.66±8.49 years were enrolled in the study after propensity score matching. The baseline characteristics of the two groups of patients were well balanced. There was no statistical difference in the operation time (P=0.100), blood loss (P=0.685), mortality rate in 30 days (P=1.000), total complication rate (P=0.829), cervical anastomosis leakage (P=0.816), mechanical ventilation (P=1.000), normal oral diet within 15 days (P=0.822) and anastomosis recurrence rate (P=0.676) between the two groups. Survival analysis showed that there was no statistical difference in survival time between the cervical group [31.83 (95%CI 8.65-55.02) months] and upper thoracic group [37.73 (95%CI 25.29-50.18) months, P=0.533]. The 5-year survival rates were 32.6% and 42.1%, respectively. Conclusion Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical ESCC without involvement of the larynx and hypopharynx may result in a similar clinical outcome to upper thoracic ESCC.