Multi-disciplinary treatment increases the survival rate of late stage pharyngeal, laryngeal or cervical ;esophageal cancers treated by free jejunal flap reconstruction after cancer resection
10.3760/cma.j.issn.0253-3766.2016.05.014
- VernacularTitle:综合治疗提高游离空肠瓣修复的晚期咽喉颈段食管癌患者生存率
- Author:
Yiming ZHU
1
;
Hong ZHANG
;
Song NI
;
Jian WANG
;
Dezhi LI
;
Shaoyan LIU
Author Information
1. 100021,国家癌症中心 中国医学科学院 北京协和医学院肿瘤医院头颈外科
- Keywords:
Subject words] Hypopharyngeal neoplasms;
Esophageal neoplasms;
Reconstructive surgical procedures;
Survival rate
- From:
Chinese Journal of Oncology
2016;38(5):389-394
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap ( FJF ) to repair the defects following tumor resection, and to analyze the effect of multi?disciplinary treatment on their survival. Methods Fifty?eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap ( FJF ) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed. Results The success rate of flap transplantation was 91.4% (53/58). The 2?year overall survival rates ( OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67. 5% and 49. 3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short?term complications had a better two?year OSR (59.0%) than the group with short?term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2?year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi?disciplinary treatment group had a significantly better 2?year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016). Conclusions Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi?disciplinary treatment can significantly improve the survival rate of late?stage hypopharyngeal and cervical esophageal cancer patients.
