PS01.178: ANALYSIS OF SURGICAL OUTCOME OF COMBINED RESECTION OF ADJACENT ORGANS IN ESOPHAGEAL CANCER

Abstract

Abstract Background If the cancer remains after chemotherapy or chemoradiotherapy for cT4b esophageal cancer, curative resection is sometimes performed. In cases where T4 is not released, combined resection of adjacent organs is necessary for R0 resection. But its significance is controversial. The aim of this study is to examine the significance of combined resection of adjuacent organs for T4 esophageal cancer. Methods Of the 209 patients who were diagnosed as cT4b esophageal cancer finally resected from 2000 to 2015, the relationship between clinicopathological factors and prognosis was retrospectively analyzed in 32 patients who underwent combined resection of T4 adjuacent organs. Results Preoperative factors: Ce/Ut/Mt/Lt = 10/14/6/2, cN Yes/No = 29/4, cM Yes/No = 7/25, preoperative treatment Yes/No = 32/0, type of preoperative treatment: chemotherapy/chemotherapy + CRT/CRT = 11/11/10, clinical response: responder/nonresponder = 22/10, T4 Organ: airway (trachea, bronchus)/blood vessel (aorta, large vessel)/gastrointestinal (pancreas, liver) = 28/2/2. Organ of ombined resection: airway/blood vessel/airway + blood vessel/digestive organ = 21/7/1/4. Postoperative factors: pT: 0/3/4 = 4/11/17. pN: 0/1–3 = 9/23, pM: 0/1 = 25/7. The 3-year overall survival rate (3yOS) of 32 patients was 31.2%. Preoperative treatment clinical effect: 3yos of responder/nonresponder = 47.8%/0%, which was significantly better in the responder(P = 0.013). Resection of respiratory tract: 3yos of yes/no = 27.3%/45.7%, (P = 0.071). There was no significant difference in prognosis regardless of cN, cM and pN status. 3yOS of pM 0/1 = 40.7%/0% (P = 0.030) and was significantly better in pM0. Multivariate analysis of OS revealed that the therapeutic effects (OR: 3.49, P = 0.040), resection of the trachea (OR: 3.10, P = 0.017) were independent prognostic factors. Conclusion Even in ct4b cases of combined resection of adjacent oragan, the 3-year survival rate was relatively good. However, the prognosis of cases with poor preoperative therapeutic effect and cases with tracheal complication were poor. It seems necessary to judge surgical indication carefully. Disclosure All authors have declared no conflicts of interest.