Oncological outcomes of cervical esophageal cancer treated primarily with surgery: a systematic review and meta-analysis

Purpose To determine the oncological outcomes of cervical esophageal cancer (CEC) treated primarily with surgery. Methods A systematic review and meta-analysis was performed according to the PRISMA guidelines. Results A total of 868 patients were included from 18 studies. Estimated pooled Overall Survival (OS) rates (95% Confidence Interval, CI) at 1 and 5 years were 74.4% (66.5–83.3), and 26.6% (20.3–34.7), respectively. Larynx non-preserving surgery (n = 229) showed an estimated pooled OS rates (95% CI) at 1 and 5 years of 59.3% (51.5–68.2) and 14.6% (8.8–24.3), respectively. On the other hand, larynx preserving surgery (n = 213) showed an estimated pooled OS rates (95% CI) at 1 and 5 years of 83.6% (78.2–89.4) and 35.1% (24.9–49.6), respectively. Conclusions Primary larynx-preserving surgery remains a valuable option for the management of CEC, with similar survival outcomes compared to primary chemoradiotherapy (CRT). On the other hand, larynx non-preserving surgery showed a significantly reduced survival, that may reflect the more advanced T classification of these tumors. Further studies are mandatory to directly compare primary surgery and primary CRT, distinguishing larynx preserving and non-preserving surgery.