Unresectable Cancer in the Broncho-esophageal Region

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  • Kawabata Kazuyoshi
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Mitani Hiroki
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Yonekawa Hiroyuki
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Fukushima Hirofumi
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Sasaki Toru
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Shimbashi Wataru
    Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research
  • Tanaka Hiroko
    Department of Diagnostic Imaging, Cancer Institute Hospital, Japanese Foundation for Cancer Research

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Other Title
  • 気管食道科領域における切除不能癌について
  • キカン ショクドウカ リョウイキ ニ オケル セツジョ フノウガン ニ ツイテ

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Abstract

Criteria for unresectability of carcinoma of the head and neck in the broncho-esophageal region include the following : 1) arterial encasement, 2) tracheal extension, and 3) prevertebral fascia involvement.<br>Concerning arterial encasement, involvement of 270° or more of the circumference of the carotid artery is generally recognized as unresectable. However, this criterion is not always accurate if the tumor is other than squamous cell carcinoma.<br>For extensive tracheal involvement, the mediastinal approach and flap reconstruction are used. Using a free radial forearm flap, entire tracheal resection can be performed. Therefore, extensive tracheal involvement is not considered unresectable.<br>Prevertebral invasion is thought to be another criterion for unresectability, if the tumor invades and fixes to the prevertebral musculature or brachial plexus.

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