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 XXXX of the thoracic esophagus with major involvement in the neck or upper @entity6830 .

@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']
@entity189 :: (MESH:D002277,Disease) :: ['carcinoma']
