Total Pharyngolaryngoesophagectomy for Cervical Esophageal Cancer: Experience of a Single Tertiary Medical Center

Background Cervical esophageal cancer always presents significant surgical challenges due to its proximity to vital structures, particularly the trachea. To obtain optimal resection margin, total pharyngolaryngoesophagectomy might be necessary when larynx or tracheal invasion occurs. Although this procedure has been performed for decades at our hospital, patient outcomes have not been previously investigated. Methods Patients who underwent total pharyngolaryngoesophagectomy were identified via the hospital’s electronic medical records. Data on operation methods, demographics (including substance use and underlying disease), and perioperative parameters such as operation time, estimated blood loss, length of intensive care unit/hospital stay, and surgical complications were recorded. Mortality and recurrence were primary and secondary endpoints. Results From 2008 to 2025, 48 patients with cervical esophageal cancer underwent total pharyngolaryngoesophagectomy. Twenty cases had co-cancers of hypopharynx, larynx, or oropharynx. All patients received McKeown procedure, mostly reconstructed with gastric tube. The 1-, 3-, and 5-year OS were 42.3%, 21.1%, and 16.9%, with a median survival of 10.1 months. When classified by pathological staging (pT0–2 and pT3–4), significant difference in OS was observed (1-year: 75.5% and 26.5%; 3-year: 37.8% and 11.4%). Recurrence occurred in 72.9% of patients. The complication rate was 83.3%, including pneumonia, arrhythmia, anastomosis leakage, graft necrosis, tracheostoma dehiscence, fistula formation, and great vessel event. Conclusion The outcomes of our cohort are comparable to previous studies. Further surveillance under various adjuvant therapies is required.