Retrospective cohort study reveals reduced cancer recurrence in esophageal cancer patients with postoperative anastomotic strictures, suggesting an unexpected protective association.
Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – long term outcomes Background This was a single institutional retrospective study. Patients with esophageal squamous cell carcinoma who underwent esophagectomy with radical lymph node dissection reconstructed by gastric tube with cervical anastomosis were included in this study. Univariable and multivariable analysis were performed to reveal the effect of anastomotic stricture on long–term outcomes. Methods This was a single institutional retrospective study. Patients with esophageal squamous cell carcinoma who underwent esophagectomy with radical lymph node dissection reconstructed by gastric tube with cervical anastomosis were included in this study. Univariable and multivariable analysis were performed to reveal the effect of anastomotic stricture on long–term outcomes. Results Of the 179 patients included in this study, 61 patients developed anastomotic stricture. In the multivariable analyses, pathological stage and lymphovascular invasion were associated with poor over all survival. Pathological stage also affected recurrence free survival (RFS), but not lymphovascular invasion. On the other hand, patients with anastomotic stricture showed better RFS than those without. Conclusion Anastomotic stricture after esophagectomy was positively associated with postoperative recurrence. It is difficult to explain these results from the factors currently we have. Further study is warranted to reveal the mechanisms that the stricture reduces the recurrence.
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Miyawaki et al. (2026) studied this question.
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