Survival after resection of oesophageal cancer
Authors:
J. Šafránek 1; J. Geiger 1; J. Šebek 1; P. Hošek 2
Authors‘ workplace:
Univerzita Karlova v Praze
Lékařská fakulta v Plzni
; Chirurgická klinika
Přednosta: prof. MUDr. Vladislav Třeška, DrSc.
1; Biomedicínské centrum
Vědecký ředitel: doc. MUDr. Milan Štengl, Ph. D.
2
Published in:
Prakt. Lék. 2018; 98(2): 69-72
Category:
Of different specialties
Overview
Methods:
A retrospective analysis of a set of patient after resection of the oesophagus for carcinoma in a period of 5 years, from the point of view of the survival time for the type and stage of the carcinoma, was performed. The patients underwent open procedures, thoracolaparotomies, or two-hole procedures with anastomoses in the chest, or, possibly, cervical circular stapler anastomoses.
Results:
Total of 71 patients was operated on for carcinoma, 50 of them underwent surgeries for adenocarcinoma, and 20 patients were operated for squamous-cell carcinoma and 1 for a non-differentiated form of carcinoma. 30-day mortality recorded was 7.9%. The average hospital stay was 21 days (10–99 days). Relaparotomy was performed in 4 cases, rethoracotomy was needed in 6 cases and tracheostomy was necessary in 9 cases, all of them for the reason of postoperative complications. Anastomosis insufficiency was recorded in 5 cases (6.6%). 3-year survival in the 5-year file was 28.4% (11.5–45.3%), which was 29.6% for adenocarcinoma and 23.2% for squamous-cell carcinoma. No significant difference in survival was found in the group of adenocarcinoma patients (50) versus squamous-cell carcinoma patients (20) p = 0.413, node affection N0 (24) vs. higher N (40): p = 0.288, and the carcinoma stages I (12), II (16) and III and higher (41), p = 0.671.
Conclusion:
The prognosis of oesophageal carcinoma despite radical surgery remains unfavorable, in our set it was not statistically significantly influenced by TMN classification, nor the type of carcinoma.
Keywords:
oesophageal carcinoma – overall survival – complications
Sources
1. Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol 2009; 27: 5062–5067.
2. Armanios M, Xu R, Forastiere AA, et al. Adjuvant chemotherapy for resected adenocarcinoma of the esophagus, gastro-esophageal junction, and cardia: phase II trial (E8296) of the Eastern Cooperative Oncology Group. J Clin Oncol 2004; 22: 4495–4499.
3. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 2012; 379: 1887–1892.
4. Keegan N, Keane F, Cuffe S, et al. ICORG 10-14: Neo-AEGIS: a randomized clinical trial of neoadjuvant and adjuvant chemotherapy (modifi ed MAGIC regimen) versus neoadjuvant chemoradiation (CROSS protocol) in adenocarcinoma of the esophagus and esophagogastric junction. Proc Am Soc Clin Oncol 2014; 32(5 Suppl): TPS4145.
5. Kelsen DP, Winter KA, Gunderson LL, et al. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol 2007; 25: 3719–3725.
6. Lee CH, Wu DC, Lee JM, et al. Carcinogenetic impact of alcohol intake on squamous cell carcinoma risk of the oesophagus in relation to tobacco smoking. Eur J Cancer 2007; 43: 1188–1199.
7. Lerut T, Nafteux P, Moons J, et al. Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma. Ann Surg 2004; 240: 962–972.
8. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Thorac Surg 2003; 238: 486–495.
9. Luketich JD, Pennathur A, Franchetti Y, et al. Minimally invasive esophagectomy: results of a prospective phase II multicenter trial-the eastern cooperative oncology group (E2202) study. Ann Surg 2015; 261(4): 702–707.
10. Gammon MD, Schoenberg JB, Ahsan H, et al. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 1997; 89: 1277–1284.
11. Hulscher JBF, van Sandick JW, de Boer AGEM, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 2002; 347: 1662–1669.
12. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001; 345: 725–730.
13. van Meerten E, van der Gaast A. Systemic treatment for oesophageal cancer. Eur J Cancer 2005; 41: 664–672.
14. Nakamura K, Kato K, Igaki H, et al. Three-arm phase III trial comparing cisplatin plus 5-FU (CF) versus docetaxel, cisplatin plus 5-FU (DCF) versus radiotherapy with CF (CF-RT) as preoperative therapy for locally advanced esophageal cancer (JCOG1109, NExT study). Jpn J Clin Oncol 2013; 43: 752–755.
15. Nishihira T, Hirayama K, Mori S. A prospective randomized trial of extended cervical and superior mediastinal lymphadenectomy for carcinoma of the thoracic esophagus. Am J Surg 1998; 175: 47–51.
16. Nguyen NT, Follette DM, Wolfe BM, et al. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg 2000; 135: 920–925.
17. Obermannová R. Moderní léčba karcinomu jícnu, gastroesofageální junkce a žaludku-update roku 2017. Gastroent Hepatol 2017; 71(5): 409–414.
18. Pennathur A, Gibson MK, Jobe BA, Luketich JD. Oesophageal carcinoma. Lancet 2013; 381: 400–412.
19. Saddoughi SA, Reinersman JM, Zhukov YO, et al. Survival after surgical resection of stage IV esophageal cancer. Ann Thorac Surg 2017; 103: 261–266.
20. Shapiro J, van Lanschot JJ, Hulshof MC, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 2015; 16: 1090–1098.
21. Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol 2011; 12: 681–692.
22. Wang BY, Lin PY, Wu SC, et al. Comparison of pathologic stage in patients receiving esophagectomy with and without preoperative chemoradiation therapy for esophageal SCC.
J Natl Compr Canc Netw 2014; 12: 1697–1705.
23. Zonča P, Peteja M, Richter V, a kol. Kompletní miniivazivní Ivor-Lewisova resekce jícnu. Rozhl Chir 2017; 96: 114–119.
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