BACKGROUND AND OBJECTIVES: In @entity189 of the thoracic esophagus, most surgeons consider that esophagectomy is contraindicated in @entity1 with clinical evidence of major extraesophageal involvement in the lower neck or peritracheal regions. However, @entity3 to these regions are commonly found even in early phases of @entity189 . With recent progress in preoperative assessment, operative technique and adjuvant therapy, esophagectomy could possibly benefit appropriately selected @entity1 . METHODS: We retrospectively analyzed results in 42 @entity1 who had major involvement in the neck or upper @entity6830 and who underwent esophagectomy with systematic lymph node dissection. We operated upon @entity1 unless lesions were assessed as definitely unresectable. Preoperatively, 32 had enlarged peritracheal nodes greater than 15 mm in diameter on computed tomography, 18 had hard @entity5 in the lower neck, 9 had recurrent @entity3746 , and 10 had findings suggestive of tracheal invasion. Preoperative radiotherapy and/or chemotherapy was given to 32 low-risk @entity1 . RESULTS: The hospital mortality rate was 4%. Bowel reconstruction was completed in all cases. No macroscopically recognizable lesion remained after operation in 35 @entity1 . Eight @entity1 were alive 5 years after esophagectomy, including 2 who had had tracheal invasion and 1 with recurrent @entity129 . The cumulative 5-year survival was 38%. CONCLUSIONS: Evidence of major involvement of the neck and/or upper @entity6830 does not always contraindicate resection. Aggressive esophagectomy combined with perioperative adjuvant therapy yielded acceptable palliation and occasional cure in cases with technically resectable lesions.

Surgical treatment for @entity189 of the thoracic esophagus with major involvement in the neck or upper XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity129 :: ('MESH:D003389', 'Disease') :: ['nerve palsy'] @entity5 :: ('MESH:D009369', 'Disease') :: ['unmobile tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma invasion', 'carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity3746 :: ('MESH:D014826', 'Disease') :: ['laryngeal nerve palsy'] @entity6830 :: ('MESH:D008479', 'Disease') :: ['mediastinum']
@entity6830 :: (MESH:D008479,Disease) :: ['mediastinum']
