Objective: To evaluate the feasibility and efficacy of salvage surgery after local failure of definitive chemoradiotherapy (dCRT) for esophageal carcinomas.
Methods: We retrospectively reviewed the esophageal cancer patients underwent salvage surgery (Group A, 26 cases) or non-surgical therapy (Group B, 11 cases) after local failure of dCRT(cT1-3N0-1M0) between July 2008 and June 2010.
Results: The rate of resection was 84.6% in Group A, R0 was 69.2%. There was no mortality after surgery. The rate of postoperative complications is 53.8%, especially pneumonia 30.8%, anastomosis leakage 11.5% and arrhythmia 7.7%. The median survival time is 11.1 months; the 2-year survival rate of Group A was 23.1% in Group A. The non-surgical therapy was given including second-line chemotherapy and esophagus stents; the median survival time is 8.1 months (3.1-15.1) in Group B. The survival rate of Group A was higher than Group B (Kaplan-Meier, P = 0.013).
Conclusion: Salvage surgery provides survival benefit for esophageal cancer patients with local persistent or recurrence after primary dCRT, despite of high morbidity.Salvage surgery should be carried out for patients with good physical condition and complete resection is technically possible.