Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases

Makino, Tomoki; Yamasaki, Makoto; Nakai, Shigeto; Momose, Kota; Yamashita, Kotaro; Tanaka, Koji; Shimamura, Kazuo; Motoori, Masaaki; Kurokawa, Yukinori; Kimura, Yutaka; Nakajima, Kiyokazu; Miyagawa, Shigeru; Eguchi, Hidetoshi; Doki, Yuichiro

doi:https://doi.org/10.1016/j.jtcvs.2025.01.017

Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases

Makino, Tomoki; Yamasaki, Makoto; Nakai, Shigeto et al.

Journal of Thoracic and Cardiovascular Surgery, 2025, 170(4), 957-968

Number of Access:174（2026-06-02 04:51 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/103889

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Title	Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases
Creator	NRID 1000080528620 1000080528620 ORCID 0000-0001-7918-4217 0000-0001-7918-4217 researchmap permalink _-_-_- _-_-_- Scopus Author ID 56339970700 56339970700 CreatorName Makino, Tomoki
	NRID 1000050444518 1000050444518 CreatorName Yamasaki, Makoto
	NRID 1000040912027 1000040912027 ORCID 0009-0002-8713-9365 0009-0002-8713-9365 Scopus Author ID 57201910767 57201910767 CreatorName Nakai, Shigeto
	NRID 1000050749752 1000050749752 ORCID 0009-0004-2623-2122 0009-0004-2623-2122 researchmap permalink kom2005 kom2005 Scopus Author ID 59711925000 59711925000 CreatorName Momose, Kota
	NRID 1000020747159 1000020747159 researchmap permalink k-yamashita k-yamashita Scopus Author ID 57191498316 57191498316 CreatorName Yamashita, Kotaro
	NRID 1000070621019 1000070621019 ORCID 0000-0001-5178-9388 0000-0001-5178-9388 researchmap permalink koji_tanaka koji_tanaka Scopus Author ID 55628548952 55628548952 CreatorName Tanaka, Koji
	NRID 1000010507205 1000010507205 researchmap permalink kazuo-shimamura kazuo-shimamura Scopus Author ID 35969640700 35969640700 CreatorName Shimamura, Kazuo
	CreatorName Motoori, Masaaki
	NRID 1000010470197 1000010470197 ORCID 0000-0002-2883-0132 0000-0002-2883-0132 researchmap permalink krkw krkw Scopus Author ID 7202562410 7202562410 CreatorName Kurokawa, Yukinori
	CreatorName Kimura, Yutaka
	NRID 1000030432537 1000030432537 ORCID 0000-0001-8635-7585 0000-0001-8635-7585 researchmap permalink project_engine project_engine Scopus Author ID 7404396263 7404396263 CreatorName Nakajima, Kiyokazu
	NRID 1000070544237 1000070544237 ORCID 0000-0003-0015-6569 0000-0003-0015-6569 researchmap permalink s-miyagawa3154 s-miyagawa3154 Scopus Author ID 55560624700 55560624700 CreatorName Miyagawa, Shigeru
	NRID 1000090542118 1000090542118 ORCID 0000-0002-2318-1129 0000-0002-2318-1129 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 CreatorName Eguchi, Hidetoshi
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 CreatorName Doki, Yuichiro
Subject	combined organ resection
	conversion surgery
	cT4b
	esophageal cancer
Description	Makino T., Yamasaki M., Nakai S., et al. Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases. Journal of Thoracic and Cardiovascular Surgery 170, 957 (2025); https://doi.org/10.1016/j.jtcvs.2025.01.017.
Abstract	Objective: To evaluate the feasibility of and long-term survival with combined organ resection for esophageal cancer (EC). The optimal treatment strategy for EC that is invading adjacent organs is not established. Methods: Ninety patients with EC invading adjacent organs who underwent combined organ resection after induction treatments during the time period 2003-2023 in our institute were eligible for the study. Short- and long-term outcomes were assessed, and survival analysis was performed to identify prognostic parameters in this cohort. Results: Most patients had primary tumors (78.9% vs 21.1% with recurrent disease). The resected organs were the trachea/bronchus in 75.6%, large vessels in 24.4%, and both in 5.6%. All but 1 patient underwent chemotherapy or chemoradiotherapy as prior induction treatment, and had R0 resection. The overall complication rate (Clavien-Dindo grade II or greater) was 54.4%, and in-hospital mortality was 2.2% (30- and 90-day mortality: 0% and 2.2%, respectively). Of the deaths, 47 (87.0%) were attributed to EC and 7 (13.0%) to other causes. Median disease-free survival was 6.5 months, and overall survival (OS) was 18.9 months. The 2-year OS values were 47.2% with trachea/bronchus resection, 38.4% with large-vessel involvement, and 37.5% if both were involved. Univariate analysis of OS demonstrated significant associations of operation time (hazard ratio [HR], 2.11; P = .0080), blood loss (HR, 2.85; P = .0003), all-layer tracheal resection (HR, 3.51; P = .0045), ypT (HR, 2.04; P = .022), and pathologic response (HR, 2.77; P = .0089). Conclusions: If patient selection is highly selected, combined organ resection may be a feasible and promising option as a part of the multidisciplinary treatment for EC invading an adjacent organ.
Publisher	Elsevier Inc.
Source Title	Journal of Thoracic and Cardiovascular Surgery
Volume (Issue)	170(4)
Page	957-968
Date of Issued	2025-09-30
Language	English
Handle URL	https://hdl.handle.net/11094/103889
PISSN	00225223
eISSN	1097685X
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.jtcvs.2025.01.017
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Journal of Thoracic and Cardiovascular Surgery. 2025, 170(4), p. 957-968
DC.title	Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases
DC.creator	Makino, Tomoki
	Yamasaki, Makoto
	Nakai, Shigeto
	Momose, Kota
	Yamashita, Kotaro
	Tanaka, Koji
	Shimamura, Kazuo
	Motoori, Masaaki
	Kurokawa, Yukinori
	Kimura, Yutaka
	Nakajima, Kiyokazu
	Miyagawa, Shigeru
	Eguchi, Hidetoshi
	Doki, Yuichiro
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-09-30
DC.identifier	https://doi.org/10.1016/j.jtcvs.2025.01.017
DC.subject	combined organ resection
	conversion surgery
	cT4b
	esophageal cancer
DC.description	Makino T., Yamasaki M., Nakai S., et al. Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases. Journal of Thoracic and Cardiovascular Surgery 170, 957 (2025); https://doi.org/10.1016/j.jtcvs.2025.01.017.
DCTERMS.abstract	Objective: To evaluate the feasibility of and long-term survival with combined organ resection for esophageal cancer (EC). The optimal treatment strategy for EC that is invading adjacent organs is not established. Methods: Ninety patients with EC invading adjacent organs who underwent combined organ resection after induction treatments during the time period 2003-2023 in our institute were eligible for the study. Short- and long-term outcomes were assessed, and survival analysis was performed to identify prognostic parameters in this cohort. Results: Most patients had primary tumors (78.9% vs 21.1% with recurrent disease). The resected organs were the trachea/bronchus in 75.6%, large vessels in 24.4%, and both in 5.6%. All but 1 patient underwent chemotherapy or chemoradiotherapy as prior induction treatment, and had R0 resection. The overall complication rate (Clavien-Dindo grade II or greater) was 54.4%, and in-hospital mortality was 2.2% (30- and 90-day mortality: 0% and 2.2%, respectively). Of the deaths, 47 (87.0%) were attributed to EC and 7 (13.0%) to other causes. Median disease-free survival was 6.5 months, and overall survival (OS) was 18.9 months. The 2-year OS values were 47.2% with trachea/bronchus resection, 38.4% with large-vessel involvement, and 37.5% if both were involved. Univariate analysis of OS demonstrated significant associations of operation time (hazard ratio [HR], 2.11; P = .0080), blood loss (HR, 2.85; P = .0003), all-layer tracheal resection (HR, 3.51; P = .0045), ypT (HR, 2.04; P = .022), and pathologic response (HR, 2.77; P = .0089). Conclusions: If patient selection is highly selected, combined organ resection may be a feasible and promising option as a part of the multidisciplinary treatment for EC invading an adjacent organ.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	103889
citation_title	Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases
citation_author	Makino, Tomoki
	Yamasaki, Makoto
	Nakai, Shigeto
	Momose, Kota
	Yamashita, Kotaro
	Tanaka, Koji
	Shimamura, Kazuo
	Motoori, Masaaki
	Kurokawa, Yukinori
	Kimura, Yutaka
	Nakajima, Kiyokazu
	Miyagawa, Shigeru
	Eguchi, Hidetoshi
	Doki, Yuichiro
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2025-09-30
citation_journal_title	Journal of Thoracic and Cardiovascular Surgery
citation_volume	170
citation_issue	4
citation_firstpage	957
citation_lastpage	968
citation_doi	https://doi.org/10.1016/j.jtcvs.2025.01.017
citation_public_url	https://hdl.handle.net/11094/103889

Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases

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