Ten-Year Survivals of Right Thoracic vs Left Thoracic Approach for Esophageal Cancer.

IF 3.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery Pub Date : 2024-09-16 DOI:10.1016/j.athoracsur.2024.09.006

Bin Li, Zezhou Wang, Yihua Sun, Hong Hu, Yawei Zhang, Jiaqing Xiang, Haiquan Chen

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引用次数: 0

Abstract

Background: Esophagectomy can be performed using various surgical techniques. The aim of this study was to understand the impact of surgery on long-term survival for esophageal cancer.

Methods: Between May 2010 and July 2012, 300 patients with esophageal cancer were randomly assigned to undergo esophagectomy with either a left or right thoracic approach. Disease-free survival (DFS) and overall survival (OS) were compared based on the per-protocol principle among 286 patients with esophageal squamous cell carcinoma determined by postoperative pathologic results (146 in the right and 140 in the left thoracic arms).

Results: The median DFS was 92 months in the right thoracic arm and 41 months in the left thoracic arm (hazard ratio, 0.73; 95% CI, 0.54-0.99; P = .045), with a cumulative 10-year DFS of 47.6% and 37.5%, respectively. The median OS was 136 months in the right thoracic arm and 99 months in the left thoracic arm (hazard ratio, 0.75; 95% CI, 0.54-1.04; P = .081), with cumulative 10-year OS of 52.4% and 43.7%, respectively. DFS and OS were comparable between the 2 arms for patients without lymph node metastasis. Conversely, for patients with lymph node metastasis, 10-year DFS was 32.7% and 21.4%, respectively (P = .018), and 10-year OS of the right and left thoracic arms was 37.9% and 25.9%, respectively (P = .012).

Conclusions: Compared with the left thoracic approach, patients who underwent esophagectomy through the right thoracic approach had better 10-year survival rates, and the survival benefit was significant for those with lymph node metastasis.

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右胸法与左胸法治疗食管癌的十年生存率对比。

背景：食管切除术可采用多种外科技术。本研究旨在了解手术对食管癌长期生存的影响：方法：2010 年 5 月至 2012 年 7 月间，300 名食管癌患者被随机分配接受左胸腔或右胸腔食管切除术。根据每方案原则，对术后病理确定的286名食管鳞状细胞癌患者（右胸146人，左胸140人）的无病生存期（DFS）和总生存期（OS）进行了比较：右胸臂和左胸臂的中位 DFS 分别为 92 个月和 41 个月（危险比为 0.73；95% 置信区间为 0.54-0.99；P=0.045），10 年累计 DFS 分别为 47.6% 和 37.5%。右胸臂和左胸臂的中位OS分别为136个月和99个月（危险比为0.75；95%置信区间为0.54-1.04；P=0.081），10年累积OS率分别为52.4%和43.7%。对于没有淋巴结转移的患者，两组的 DFS 和 OS 相当。相反，对于有淋巴结转移的患者，右胸臂和左胸臂的10年DFS分别为32.7%和21.4%（P=0.018），10年OS分别为37.9%和25.9%（P=0.012）：结论：与左侧胸腔入路相比，通过右侧胸腔入路进行食管切除术的患者的10年生存率更高，且淋巴结转移患者的生存获益更显著。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Thoracic Surgery 医学-呼吸系统

CiteScore

6.40

自引率

13.00%

发文量

1235

审稿时长

42 days

期刊介绍： The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. The Annals of Thoracic Surgery features: • Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques • New Technology articles • Case reports • "How-to-do-it" features • Reviews of current literature • Supplements on symposia • Commentary pieces and correspondence • CME • Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery. An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.