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Does neoadjuvant therapy increase postoperative complications of esophagectomy?

BACKGROUND: Esophageal cancer is the eighth most frequent type of cancer in the population in the world, and in Brazil 10.630 new cases are estimated for the year 2010. In curative treatment, esophagectomy stands out in its various treatment modalities. AIM: To assess by means of a retrospective nonrandomized the perioperative complications of patients submitted to esophagectomy for squamous cell carcinoma of the esophagus, with or without neoadjuvant therapy. METHODS: Were analyzed 123 patients operated, undergoing mostly (80%) transmediastinal esophagectomy with cervical esophagogastric anastomosis, distributed as follows: 81 (65.8%) underwent radiotherapy neo-adjuvant, 16 (13%) chemoradiotherapy neoadjuvant and 26 (21,2%) to surgery alone. RESULTS: Major complications considered were: intraoperative hemorrhage (4%), pneumothorax / hemothorax (73.1%), pneumonia (20.3%) and fistula and anastomotic stenosis (44.7%). No significant differences in complications between the groups, except for pneumothorax / hemothorax in which there was a lower incidence in the group of surgery alone. Overall mortality was 14 cases (8.8%), unrelated to the treatment used. CONCLUSION: The neoadjuvant chemoradiotherapy in order to obtain better survival rates and complete resection resulted in no increase in perioperative complications.

Esophageal neoplasms; Surgery; Chemotherapy; Radiotherapy


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