Outcomes of esophagectomy for patients with esophageal squamous cell carcinoma accompanied by recurrent laryngeal nerve palsy at diagnosis

Abstract

Background Hoarseness is one of the classical symptoms in patients with locally advanced thoracic esophageal squamous cell carcinoma (ESCC), and it results from recurrent laryngeal nerve palsy, which is caused by nodal metastasis along the recurrent laryngeal nerve or by main tumors. We reviewed the short-term and long-term results of esophagectomy for patients with locally advanced ESCC and hoarseness at diagnosis. Patients Patients who initially presented with hoarseness from recurrent laryngeal nerve palsy between 2009 and 2018 and underwent esophagectomy for thoracic ESCC were eligible for this study. Pharyngolaryngectomy or cervical ESCC were exclusionary. Results A total of 15 patients were eligible, and 14 underwent resection of the recurrent laryngeal nerves. The remaining patient had nerve-sparing surgery. Nine patients (60%) had post-operative complications ≥ Clavien–Dindo class II and, pulmonary complications were most common. Two patients (13%) died in the hospital. The 5-year overall survival rate for all patients was 16%. Age (≤ 65 years), cT1/T2 tumor, and remarkably good response to neoadjuvant treatment were likely related to longer survival; however, these relationships were not statistically significant. Conclusions Esophagectomy for ESCC patients who are diagnosed with recurrent laryngeal nerve paralysis at initial presentation could be a treatment option if the patient is relatively young, has a cT1/T2 tumor, or shows a remarkably good response to neoadjuvant treatment. However, clinicians should be aware of the possibility of postoperative pulmonary complications, which were frequently observed with the procedure.

Development and validation of the Convalescence Symptom Assessment Scale for EsophageCtomy patients

“…This serves as a reminder to healthcare professionals to take effective prevention and control measures for people with diarrhoea and to pay close attention to the manufacturing and use the nutrient disturbed sleep and hoarseness. The hoarseness caused by lymph node dissection and damage to the recurrent laryngeal nerve during the operation usually does not fully recover until about 3-6 months after the operation (Ozaki et al, 2022), which is also included in this dimension. Dimension-4 (psychosocial symptoms) refers to the psychological and social problems that may occur in oesophageal cancer patients during postoperative recovery, including worry, anxiety, sad, helplessness, societal self-isolation and social isolation.…”