Hybrid esophagectomy for oesophageal cancer: long-term results. A single-centre experience
Status PubMed-not-MEDLINE Language English Country Poland Media print-electronic
Document type Journal Article
PubMed
34136024
PubMed Central
PMC8193741
DOI
10.5114/wiitm.2020.100893
PII: 42415
Knihovny.cz E-resources
- Keywords
- hybrid oesophagectomy, long-term outcome, oesophageal cancer, pathological complete response,
- Publication type
- Journal Article MeSH
INTRODUCTION: The authors report long-term outcomes in patients who received neoadjuvant chemoradiotherapy and consequently underwent hybrid oesophagectomy for oesophageal cancer (OC). AIM: To evaluate long-term outcomes in patients suffering from OC, who underwent hybrid oesophagectomy. MATERIAL AND METHODS: Our cohort consisted of patients suffering from OC, who received neoadjuvant chemoradiotherapy. Hybrid esophagectomy was performed 8-10 weeks after oncological treatment. RESULTS: Ninety-four patients underwent surgery for OC from 2011 to 2015. Histology revealed adenocarcinoma in 60.6%, squamous cell carcinoma (SCC) in 36.2%, and other type of cancer in 3.2%. Seventy-three (77.7%) patients with advanced stage (T3-4, N0-2, M0) were indicated to receive neoadjuvant chemoradiotherapy (nCRT). Trans-hiatal hybrid oesophagectomy was performed in 83 (88.3%) patients. Transthoracic hybrid oesophagectomy was performed in 11 (11.7%) patients. Histology of the resected specimens of 18 (24.7%) patients did not reveal OC, i.e. pathological complete response (pCR). In our cohort, we proved an association between occurrence of pCR and age as well as disease-free survival (DFS). The patients who presented with pCR were significantly younger - below 60 years of age (p = 0.017). They also showed significantly higher mean DFS (p = 0.004). CONCLUSIONS: Combined oesophagectomy with neoadjuvant chemoradiotherapy results in a better long-term outcome in patients suffering from oesophageal cancer. In our set of patients who underwent hybrid esophagectomy, satisfactory short-term and especially long-term results of surgical treatment for oesophageal cancer were observed.
See more in PubMed
GLOBOCAN 2018: Estimated cancer incidence, mortality and prevalence worldwide in 2018. Available from: http://gco.iarc.fr/today/data/factsheets/cancers/6-Oesophagus-fact-sheet.pdf.
Ninomiya I, Osugi H, Fujimura T, et al. Thoracoscopic esophagectomy with extended lymph node dissection in the left lateral position: technical feasibility and oncologic outcomes. Dis Esophagus. 2014;27:159–67. PubMed
Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 2018;41:210–5. PubMed
Bonavina L, Asti E, Sironi A, et al. Hybrid and total minimally invasive esophagectomy: how I do it. J Thorac Dis. 2017;9(Suppl 8):S761–72. PubMed PMC
Meng F, Li Y, Ma H, et al. Comparison of outcomes of open and minimally invasive esophagectomy in 183 patients with cancer. J Thorac Dis. 2014;6:1218–24. PubMed PMC
Vrba R, Vrána D, Neoral Č, et al. Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients. Videosurgery Miniinv. 2019;14:52–9. PubMed PMC
Thibault V, Alexandru L, Guillaume P. Hybrid esophagectomy. J Thorac Dis. 2019;11(Suppl 5):S723–7. PubMed PMC
Vrba R, Aujeský R, Stašek M, et al. Esophageal cancer results of surgical treatment at the Department of Surgery I at the University Hospital Olomouc. Rozhl Chir Winter. 2018;97:342–8. PubMed
Tachibana M, Kinugasa S, Hirahara N, et al. Lymph node classification of esophageal squamous cell carcinoma and adenocarcinoma. Eur J Cardiothorac Surg. 2008;34:427–31. PubMed
Gulben K, Irkin F, Yazı M, et al. Prognostic significance of number of lymph node metastasis on survival in patients with pathological T3 esophageal carcinoma. Neoplasma. 2017;64:131–5. PubMed
Mariette C, Markar SR, Dabakuyo-Yonli TS, et al. Hybrid minimally invasive esophagectomy for esophageal cancer. N Engl J Med. 2019;380:152–62. PubMed
Wlodarczyk J, Kużdżał J. Stenting as a palliative method in the management of advanced squamous cell carcinoma of the oesophagus and gastro-oesophageal junction. Videosurgery Miniinv. 2016;11:1–8. PubMed PMC
Zhang Z, Zhang H. Impact of neoadjuvant chemotherapy and chemoradiotherapy on postoperative cardiopulmonary complications in patiens with esophagea lcancer. Dis Esophagus. 2017;30:1–7. PubMed
Ott K, Bader FG, Lordick F, et al. Surgical factors influence the outcome after Ivor-Lewis esophagectomy with intrathoracic anastomosis for adenocarcinoma of the esophagogastric junction: a consecutive series of 240 patient at an experienced center. Ann Surg Oncol. 2009;16:1017–25. PubMed
Wormuth JK, Heitmiler RF. Esophageal conduit necrosis. J Thorac Surg Clin. 2006;16:11–22. PubMed
Haga Y, Wada Y, Takeuchi H, et al. Prediction of anasto-motic leak and its prognosis in digestive surgery. World J Surg. 2011;35:716–22. PubMed
Atkins BZ, Shah AS, Hutcheson KA, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg. 2004;78:1170–6. PubMed
Xing XZ, Gao Y, Wang HJ, et al. Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy. World J Emerg Med. 2016;7:44–9. PubMed PMC
Raymond DP, Seder CW, Wright CD, et al. Predictors of major morbidity or mortality after resection for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database Risk Ajustment Model. Ann Thorac Surg. 2016;102:207–14. PubMed PMC
Dhungel B, Diggs BS, Hunter JG, et al. Patient and peri-operative predictors of morbidity and mortality after esophagectomy: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005-2008. J Gastrointest Surg. 2010;14:1492–501. PubMed
van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–84. PubMed
Chirieac LR, Swisher SG, Ajani JA, et al. Posttherapy pathologic stage predicts survival in patients with esophageal carcinoma receiving preoperative chemoradiation. Cancer. 2005;103:1347–55. PubMed
Darnton SJ, Archer VR, Stocken DD, et al. Preoperative mitomycin, ifosfamide, and cisplatin followed by esophagectomy in squamous cell carcinoma of the esophagus: pathologic complete response induced by chemotherapy leads to long-term survival. J Clin Oncol. 2003;21:4009–15. PubMed
Meluch AA, Greco FA, Gray JR, et al. Preoperative therapy with concurrent paclitaxel/carboplatin/infusional 5-FU and radiation therapy in locoregional esophageal cancer: final results of a Minnie Pearl Cancer Research Network phase II trial. Cancer J. 2003;9:251–60. PubMed
Lin JW, Hsu CP, Yeh HL, et al. The impact of pathological complete response after neoadjuvant chemoradiotherapy in locally advanced squamous cell carcinoma of esophagus. J Chin Med Assoc. 2018;81:18–24. PubMed
Alnaji RM, Du W, Gabriel E, et al. Pathologic complete response is an independent predictor of improved survival following neoadjuvant chemoradiation for esophageal adenocarcinoma. J Gastrointest Surg. 2016;20:1541–6. PubMed