Thoracic endovascular aortic repair for advanced esophageal cancer invading the aorta: A prognosis analysis among 124 patients.
Journal
JTCVS open
Journal Volume
28
ISSN
2666-2736
Date Issued
2025-12
Author(s)
Lu, Hsiao-Hung
Chen, Ke-Cheng
Chang, Chih-Yang
Huang, Pei-Ming
Lin, Mong-Wei
Kuo, Shuenn-Wen
Lee, Jang-Ming
Abstract
Advanced esophageal cancer invading the aorta is considered an unresectable disease with a poor prognosis. We evaluated the clinical impact of elective thoracic endovascular aortic repair implantation on the prognosis of such patients.We retrospectively evaluated patients with advanced esophageal cancer and aortic invasion who underwent thoracic endovascular aortic repair to assess its prognostic impact under multimodal treatment.Overall, 124 patients were enrolled. Among these, 16 patients underwent salvage thoracic endovascular aortic repair in response to bleeding from an aorto-esophageal fistula, 46 patients received elective thoracic endovascular aortic repair with esophagectomy after diagnosing aortic invasion by a tumor, and 62 patients underwent elective thoracic endovascular aortic repair without esophagectomy after diagnosing aortic invasion by a tumor. The median overall survival time was 3.57, 6.90, and 16.90 months for patients who underwent salvage thoracic endovascular aortic repair, elective thoracic endovascular aortic repair without esophagectomy, and elective thoracic endovascular aortic repair with esophagectomy, respectively ( < .001). Under multivariate analysis, compared with patients who underwent salvage thoracic endovascular aortic repair, those who received elective thoracic endovascular aortic repair with and without esophagectomy had reduced odds ratios of mortality (95% CI) of 0.21 (0.11-0.41) and 0.38 (0.20-0.74), respectively.Compared with salvage thoracic endovascular aortic repair, elective thoracic endovascular aortic repair implanted after diagnosis for esophageal cancer with aortic invasion is associated with improved overall survival. It provides the opportunity for esophagectomy, further prolonging survival compared with those without esophagectomy.
Subjects
advanced esophageal cancer
aortic invasion
aorto-esophageal fistula
elective TEVAR
esophagectomy
salvage TEVAR
Type
journal article