Outcome of Delayed versus Timely Esophagectomy after Chemoradiation for Esophageal Adenocarcinoma

Abstract Objective Salvage and delayed esophagectomy after chemoradiation (CRT) have been associated with increased morbidity and mortality, but recent series have shown similar outcomes compared to timely esophagectomy. We aim to evaluate outcomes for delayed and salvage esophagectomy for esophageal adenocarcinoma utilizing a large national database. Methods The National Cancer Database was queried from 2004 to 2014 for patients with clinical stage II or III esophageal adenocarcinoma who underwent preoperative CRT and esophagectomy. Patients with surgery Results A total of 8,489 patients met criteria. The median post-radiation interval was 49 (40-61) days for timely esophagectomy and 109 (97-132) days for delayed esophagectomy. The delayed group was more likely to be of black race (2.3% vs 1.2%, p Conclusions In this large, retrospective database study, despite increased perioperative mortality, delayed and salvage esophagectomy for adenocarcinoma appear to have similar long-term survival compared to timely esophagectomy. Delayed and salvage esophagectomy may be offered to patients who do not receive timely esophagectomy after CRT.