oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2023-22-4-101-108oncotomsk-2685Research ArticleОБЗОРЫREVIEWSЛечение рака шейного отдела пищевода: систематический обзор и мета-анализTreatment of cervical esophageal carcinoma: systematic review and meta-analysisЧичеватовД. А.ChichevatovD. A.

Чичеватов Дмитрий Андреевич, доктор медицинских наук, профессор кафедры хирургии, Researcher ID (WOS): Q-3647-2017.

440026, г. Пенза, ул. Красная, 40

Dmitry A. Chichevatov, MD, Professor, Department of Surgery, Researcher ID (WOS): Q-3647-2017. 

40, Krasnaya St., 440026, Penza

chichevatov69@mail.ruСеливерстоваО. М.SeliverstovaO. M.

Селиверстова Ольга Михайловна, ординатор кафедры хирургии 

440026, г. Пенза, ул. Красная, 40

Olga M. Seliverstova, MD, Resident, Department of Surgery 

40, Krasnaya St., 440026, Penza

ДмитриевС. П.DmitrievS. P.

Дмитриев Сергей Павлович, ассистент кафедры хирургии Researcher ID (WOS): HOH-1143-2023. 

440026, г. Пенза, ул. Красная, 40

Sergei P. Dmitriev, MD, Assistant, Researcher ID (WOS): HOH1143-2023.

40, Krasnaya St., 440026, Penza

ФГБОУ ВО «Пензенский государственный университет»РоссияPenza State UniversityRussian Federation202308092023224101108Copyright © Чичеватов Д.А., Селиверстова О.М., Дмитриев С.П., 20232023Чичеватов Д.А., Селиверстова О.М., Дмитриев С.П.Chichevatov D.A., Seliverstova O.M., Dmitriev S.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2685

Лечение рака шейного отдела пищевода (РШП) до настоящего времени является предметом дискуссии. Выбор метода лечения все еще остается неопределенным. Цель исследования ‒ оценить целесообразность хирургического вмешательства при лечении РШП. Материал и методы. Произведен поиск оригинальных исследований в базах данных. В настоящий обзор включено 24 статьи, соответствующие критериям включения для анализа, таким как (1) оригинальные исследования, опубликованные с 2000 по 2022 г., (2) первичная локализация опухоли в шейном отделе пищевода, (3) плоскоклеточный рак, (4) наличие клинической характеристики исследуемых групп (возраст, пол, Т, N, M, клиническая стадия), (5) подробное описание применяемых методов лечения (лучевая терапия, химиотерапия, хирургические операции), (6) наличие информации об общей выживаемости. Эти публикации включали две группы из 14 хирургических и 17 нехирургических подгрупп. Персональные данные пациентов и оценка параметров были восстановлены на основании первичных графиков кривых Каплана–Мейера. Результаты. Анализ выявил выраженную гетерогенность (I2 =83,76 %; 95 % ДИ, 71,40–92,16) «random effects» модели. Использование хирургического метода в лечении РШП не повлияло на 3-летнюю общую выживаемость (р=0.665); 46.4 % (95 % ДИ 37,4–55,6) против 43,7 % (95 % ДИ 35,3–51,6) соответственно. Были обсуждены возможности применения хирургических и нехирургических методов лечения. Заключение. В лечении РШП химиолучевая терапия и радикальные операции взаимно неинфериорны. Эти методы лечения в равной степени сопряжены с развитием нежелательных эффектов и осложнений, что может ухудшать функциональный результат и показатели выживаемости. Выбор метода лечения может зависеть от степени ответа на индукционную терапию. Последний аспект требует дальнейшего изучения.

Objectives. Up to date managing a cervical esophageal carcinoma (CEC) has remained a controversial challenge. The choice of treatment is still uncertain. In the present review we attempted to assess eligibility of surgery in treatment of CEC. Material and Methods. We have enquired particular publication databases and the enquiries yielded 24 contributions matching study selection criteria such as (1) original articles published from 2000 to 2022, (2) primary tumor localization in the cervical esophagus, (3) squamous cell carcinoma, (4) available characteristics of studied groups (age, sex, T, N, M, stage), (5) detailed description of curative procedures (radiation therapy, chemotherapy, surgery), (6) information about overall survival. These publications represented two arms of 14 surgical and 17 non-surgical subgroups to analyze. Individual patient data and parameter estimates have been renewed on the basis of original Kaplan‒Meier curves plotted. Results. The analysis revealed a highly heterogeneous (I2 =83.76 %; 95 % CI, 71.40–92.16) random effects model. Including a surgical option into treatment of CEC did not affect 3-year overall survival (р=0.665); 46.4 % (95 % CI, 37.4–55.6) vs 43.7 % (95 % CI, 35.3–51.6), respectively. Possibilities of surgical and non-surgical modalities employment were discussed. Conclusion. In treatment of CEC CRT and surgery are non-inferior to each other. These modalities are evenly associated with posterior side effects and complications, which adversely affect functional outcomes and survival. The choice of a treatment mode may depend on tumor response to induction therapy. The latter demands further investigations.

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The authors declare that there are no conflicts of interest present.