280 CONVERSION SURGERY FOR BORDERLINE T4 ESOPHAGEAL CANCER

Abstract

\n \n \n Due to development of neo-adjuvant chemotherapy or chemoradiotherapy, the possibility of surgical resection for borderlint T4 esophageal cancer that seems difficult to resect is emerging. We retrospectively examine the effects of conversion surgery in patients for esophageal cancer as part of multidisciplinary treatment.\n \n \n \n We undergo 364 cases esophagectomy between Jan 2011 and Dec 2018, and of the 10 cases were diagnosed as borderline resectable esophageal cancer patients at first admission. These 10 cases were undergone conversion surgery after chemotherapy. We retrospectively examined preoperative and postoperative treatment and their prognosis.\n \n \n \n The chemotherapy regimens given above 10 cases were DCF (4cases) and FP (6 cases). Borderline target organs: Aorta (4 cases), Left main bronchus(6 cases), LN invasion to pancreas (1 case). R0 surgery was achieved in 8 of 10 cases, and the pathological response was G1a: 5 cases, G1b: 2 cases, G2: 3 cases. The median number of lymph node metastases is 3 (0–19), with recurrence in 6 cases, and the median time to recurrence is 7\xa0months (2–21\xa0months). Treatment was performed in all 6 cases after recurrence. Four patients had radiation therapy, but their prognosis was severe: 2 cases survived and 4 cases died.\n \n \n \n Conversion surgery as a multidisciplinary treatment still can not provide a satisfactory prognosis, so additional treatment strategies including radiation and more effective utilization of other modalities are expected.\n