UNASSIGNED: The therapeutic strategy to be recommended in case of recurrent or persistent @entity1544 after completed definitive chemoradiotherapy (dCRT) has to be documented. Salvage esophagectomy has traditionally been recognized as a viable option, but many clinicians oppose the use of surgery due to the associated excessive morbidity and mortality. 'Second-line' chemoradiotherapy (CRT) without surgery may offer a treatment alternative in these difficult and demanding clinical situations. Until now, no comprehensive attempt has been carried out to compare the respective therapeutic options. A systematic literature search was performed focusing on studies comparing survival and treatment-related mortality in @entity1 submitted to salvage esophagectomy or second-line CRT for recurrent or persistent @entity1721 after dCRT. Hazard ratios and risk ratios were calculated to compare the effect of these therapeutic strategies on overall survival and treatment-related mortality, respectively. Four studies containing 219 @entity1 , with persistent or recurrent @entity1721 after dCRT, were included in the meta-analysis. The analysis revealed an overall survival benefit following salvage esophagectomy with a pooled hazard ratio for death of 0.42 (95% confidence interval 0.21-0.86, P = 0.017) compared with second-line CRT. A treatment-related mortality of 10.3% was recorded in the 36 @entity1 who were submitted to salvage esophagectomy, while it was impossible to perform a meta-analysis comparing treatment-related mortality between the groups. Salvage esophagectomy offers significant gain in long-term survival compared with second-line CRT, although the surgery is potentially at a price of a high treatment-related mortality.

Systematic review and meta-analysis on the significance of salvage esophagectomy for persistent or recurrent XXXX after definitive chemoradiotherapy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1544 :: ('MESH:D018307', 'Disease') :: ['squamous cell esophageal cancer'] @entity1721 :: ('MESH:C562729', 'Disease') :: ['esophageal squamous cell carcinoma']
@entity1721 :: (MESH:C562729,Disease) :: ['esophageal squamous cell carcinoma']
