{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:07:02Z","timestamp":1793653622443,"version":"4.5.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Salvage esophagectomy is associated with high morbidity and mortality rates. We performed a systematic review and meta\u2010analysis to evaluate the efficacy and safety of salvage esophagectomy for unresectable locally advanced (T4) esophageal squamous cell carcinoma (ESCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched the MEDLINE (PubMed) databases, the Cochrane Library databases, Ichushi\u2010Web (the databases of the Japan Medical Abstract Society), and CiNii (the Academic Information Search Service of the National Institute of Information from Japan) for articles on salvage esophagectomy for T4 ESCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies (208 cases) were eligible for meta\u2010analysis. The overall postoperative complications rate (Clavien\u2013Dindo grade \u2265\u2009III) was 30% (95% CI: 23\u201338,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%); anastomotic leak rate was 18% (95% CI: 13\u201325,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200915%); pulmonary complication rate was 31% (95% CI: 20\u201342,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200963%); mortality rate was 7% (95% CI: 3\u201311,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%); and R0 resection rate was 72% (95% CI: 59\u201383,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200972%). A meta\u2010analysis of survival was not performed due to heterogeneous reporting across studies. However, overall survival was reported to be higher in patients achieving R0 resection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Salvage esophagectomy for cT4 ESCC is associated with significant morbidity, particularly a high anastomotic leak rate of 18%. The procedure should be reserved for carefully selected patients in whom R0 resection is highly feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70233","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T08:21:39Z","timestamp":1777969299000},"page":"1441-1449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Systematic Review and Meta\u2010Analysis on the Efficacy and Safety of Salvage Esophagectomy for\n                    <scp>T4<\/scp>\n                    Esophageal Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-3132","authenticated-orcid":false,"given":"Makoto","family":"Sakai","sequence":"first","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of General Surgical Science Gunma University, Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Kuriyama","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of General Surgical Science Gunma University, Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2562-2127","authenticated-orcid":false,"given":"Kazue","family":"Nagai","sequence":"additional","affiliation":[{"name":"Gunma University Center for Food Science and Wellness  Maebashi Japan"},{"name":"Innovative Medical Research Center Gunma University Hospital  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7173-7945","authenticated-orcid":false,"given":"Ken","family":"Shirabe","sequence":"additional","affiliation":[{"name":"Department of General Surgical Science Gunma University, Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Saeki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of General Surgical Science Gunma University, Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12835"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12364"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyh107"},{"key":"e_1_2_10_6_1","first-page":"1623","article-title":"Chemoradiotherapy of Locally Advanced Esophageal Cancer: Long\u2010Term Follow\u2010Up of a Prospective Randomized Trial (RTOG 85\u201001)","volume":"281","author":"Cooper J. 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