P1.178. Perioperative, Survival, and Oncologic Outcomes After Salvage Versus Planned Esophagectomy

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ID: 325928
2026
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Ranked #29 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background Salvage esophagectomy represents an alternative strategy to standard multimodal treatment of resectable esophageal cancer. However, its definition is heterogeneous and further investigation is required to better characterize outcomes and inform patient selection. Methods Esophagectomies performed between January 2010 and 2023 were retrospectively analysed. Patients were stratified into planned esophagectomy (PE) and salvage esophagectomy (SE) groups. SE was defined as surgery performed for: 1. Residual disease after definitive chemoradiotherapy (dCRT), 2. Recurrence post-dCRT, 3. dCRT downstaging T4b to resectable, 4. Oligometastatic disease, 5. Recurrent disease after previous resection, or 6. Delayed time interval post-neoadjuvant CRT. Outcomes measured included perioperative variables and complications, and overall- (OS) and disease-free survival (DFS). Results Among 492 patients, 66 (14.6%) underwent SE. Compared to the PE group, SE patients were younger, more frequently male, had a higher proportion of squamous cell carcinoma, and had less N3 disease. SE was associated with longer median hospital stays (12.5 vs. 10 days, p=0.009), higher rates of anastomotic leaks (21.2% vs. 4.1%, p<0.001), respiratory complications (27.3% vs. 7.5%, p<0.001), major complications (31.8% vs. 10.9%, p<0.001), and in-hospital mortality (10.6% vs. 1.3%, p<0.001). Despite increased perioperative morbidity, there were no significant differences in OS or DFS on log-rank analysis. On multivariable analysis, SE was not independently associated with worse OS or DFS. Conclusion SE was associated with higher perioperative morbidity and mortality than PE, but did not compromise long-term OS or DFS. Favourable survival outcomes were observed in patients with residual disease post-dCRT and in selected cases of stable oligometastatic disease. Indication-specific risk stratification and considered multidisciplinary patient selection are crucial when considering salvage esophagectomy.
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Authors Jin-soo Park, Frances Allison, Jonathan Allen, R.A. McLaughlin, Elena Elimova, Aruz Mesci, Elliot Wakeam, Jonathan Yeung
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.326
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.326/70760545/doag077.326.pdf
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