Diseases of the Esophagus最新文献_第10页

Endoscopic submucosal dissection for superficial esophageal cancer in the remnant esophagus after esophagectomy. 内镜黏膜下剥离术治疗食管切除术后残余食管中的浅表食管癌。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae070

Yugo Suzuki, Daisuke Kikuchi, Satoshi Nakamura, Toshiro Iizuka, Yorinari Ochiai, Junnosuke Hayasaka, Masaki Ueno, Harushi Udagawa, Shu Hoteya

{"title":"Endoscopic submucosal dissection for superficial esophageal cancer in the remnant esophagus after esophagectomy.","authors":"Yugo Suzuki, Daisuke Kikuchi, Satoshi Nakamura, Toshiro Iizuka, Yorinari Ochiai, Junnosuke Hayasaka, Masaki Ueno, Harushi Udagawa, Shu Hoteya","doi":"10.1093/dote/doae070","DOIUrl":"10.1093/dote/doae070","url":null,"abstract":"Treatment of esophageal cancer in the remnant esophagus after esophagectomy is highly invasive, therefore, early detection and minimally invasive treatment are considered necessary. Consequently, we aimed to clarify the safety and efficacy of endoscopic submucosal dissection (ESD) for residual esophageal cancer compared to that for esophageal cancer in a normal cervical esophagus. This study involved 47 patients with 59 residual esophageal cancers and 92 patients with 107 cervical esophageal cancers in normal esophagus who underwent ESD between January 2008 and December 2023. Their clinicopathological findings and long-term outcomes were retrospectively collected and evaluated. The median tumor diameter was 13 mm, and the median procedure time was 31 minutes in remnant esophagus group, with no significant difference between the two groups. No serious complications such as perforation, massive intraoperative bleeding, and pneumonia were observed in the remnant group, except for one case of postoperative bleeding. The rates of complete resection and disease specific survival were not significantly different between two groups, with complete resection rate of 86.4% and 5-year disease-specific survival rate of 95.7% in the remnant esophagus group. No local recurrence was observed during the median observation period of 43 months in the remnant esophagus group. ESD for superficial cancer of the remnant esophagus showed a high complete resection rate without serious complications and good local-regional control with no evidence of local recurrence. This indicates that ESD is a safe and useful treatment for superficial cancer of the remnant esophagus.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reasons for fear of cancer recurrence after endoscopic treatment of T1 esophageal adenocarcinoma. A semi-structured interview study. T1 食管腺癌内镜治疗后担心癌症复发的原因。半结构式访谈研究。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae067

Wilda D Rosmolen, Roos E Pouw, Jacques J Bergman, Mirjam A G Sprangers, Pythia T Nieuwkerk

{"title":"Reasons for fear of cancer recurrence after endoscopic treatment of T1 esophageal adenocarcinoma. A semi-structured interview study.","authors":"Wilda D Rosmolen, Roos E Pouw, Jacques J Bergman, Mirjam A G Sprangers, Pythia T Nieuwkerk","doi":"10.1093/dote/doae067","DOIUrl":"10.1093/dote/doae067","url":null,"abstract":"Prior research has shown that patients with early Barrett's neoplasia treated endoscopically report at least the same level of fear for cancer recurrence as patients treated surgically for a more advanced disease stage. The aim of this qualitative study was to gain insight into the reasons why endoscopically treated patients fear or not fear cancer recurrence. Patients treated endoscopically for T1 esophageal adenocarcinoma participated in a semi-structured interview. Patients were asked open questions about their fear of cancer recurrence and presented an a priori list of possible reasons for experiencing or not experiencing fear of cancer recurrence. Data saturation was reached with 12 patients who added 7 new reasons. Reasons that induced fear of cancer recurrence were related to physical symptoms, if cancer was diagnosed as an accidental finding and experiences with cancer in close relations. Endoscopic surveillance was mentioned as a reason for not experiencing fear of cancer recurrence. Patients reduced their fear of cancer recurrence by talking to close relations and seeking distraction. Caregivers reduced patients fear of cancer recurrence by giving adequate information and by showing photo of the treatment and the results of the treatment. According to patients with early Barrett's neoplasia, receiving comprehensible information about the risk of recurrence and potential symptoms that may or may not be indicative of cancer recurrence, and continuing endoscopic surveillance, reduced fear of cancer recurrence. We recommend that healthcare providers discuss fear of cancer recurrence with their patients to enable tailoring information provision to their needs.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TikTok and Bilibili as health information sources on gastroesophageal reflux disease: an assessment of content and its quality. TikTok 和 Bilibili 作为有关胃食管反流病的健康信息来源：内容及其质量评估。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae081

Xuyan Liu, Qingzhou Kong, Yihao Song, Ruihao Ding, Longfei Sun, Leiqi Xu, Yueyue Li, Xiuli Zuo, Yanqing Li

{"title":"TikTok and Bilibili as health information sources on gastroesophageal reflux disease: an assessment of content and its quality.","authors":"Xuyan Liu, Qingzhou Kong, Yihao Song, Ruihao Ding, Longfei Sun, Leiqi Xu, Yueyue Li, Xiuli Zuo, Yanqing Li","doi":"10.1093/dote/doae081","DOIUrl":"10.1093/dote/doae081","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is a global chronic disease. Short video platforms make it easy for patients with GERD to obtain medical information. However, the quality of information from these videos remains uncertain. This study aimed to systematically assess videos related to GERD on TikTok and Bilibili. We conducted a search and gathered 241 Chinese videos related to GERD and recorded the essential information. Two independent evaluators assessed each video based on the completeness of six components of the GERD guidelines, and assessed the quality and reliability of the information in the videos using recognition tools. Finally, videos from different sources were compared. The uploaders of most videos were medical professionals (86.7%, n = 209). The content was mainly about symptoms and treatment. The quality of the videos information varied depending on the sources. Among videos posted on Bilibili, those posted by medical professionals had a lower content score for definition (P < 0.001). Videos produced by non-gastroenterologists had the highest mean modified DISCERN. (The DISCERN scoring tool was initially created for assessing written publications, but nowadays, it is frequently leveraged for appraising various health-related videos. Details can be found in the text) quality of the videos information was acceptable; however, the content varied significantly depending on the type of source used. Videos with broad content should be carefully screened to meet more needs.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tumor thickness is associated with metastasis in patients with submucosal invasive adenocarcinoma of the esophagogastric junction. 肿瘤厚度与食管胃交界处粘膜下浸润性腺癌患者的转移有关。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae083

Nobuhisa Minakata, Tomohiro Kadota, Shingo Sakashita, Atsushi Inaba, Hironori Sunakawa, Kenji Takashima, Keiichiro Nakajo, Tatsuro Murano, Kensuke Shinmura, Yusuke Yoda, Hiroaki Ikematsu, Takeo Fujita, Takahiro Kinoshita, Tomonori Yano

{"title":"Tumor thickness is associated with metastasis in patients with submucosal invasive adenocarcinoma of the esophagogastric junction.","authors":"Nobuhisa Minakata, Tomohiro Kadota, Shingo Sakashita, Atsushi Inaba, Hironori Sunakawa, Kenji Takashima, Keiichiro Nakajo, Tatsuro Murano, Kensuke Shinmura, Yusuke Yoda, Hiroaki Ikematsu, Takeo Fujita, Takahiro Kinoshita, Tomonori Yano","doi":"10.1093/dote/doae083","DOIUrl":"10.1093/dote/doae083","url":null,"abstract":"In submucosal invasive adenocarcinoma of the esophagogastric junction (pT1b-SM AEG), the extent of tumor submucosal (SM) invasion is measured using the vertical depth of SM invasion with the muscularis mucosa. This study aimed to investigate whether tumor thickness and depth of invasion without accounting for muscularis mucosa were superior to the vertical depth of SM invasion as metastasis predictors. We enrolled patients with pT1b-SM AEG who underwent endoscopic resection or surgical resection (SR) at our institution between January 2011 and September 2019 and were followed up for ≥2 years. The relationship between metastasis and clinicopathological factors was examined. Metastasis was defined as pathologically confirmed lymph node metastasis in the surgical specimen or recurrence during follow-up. This study included 57 patients (44 men; median age, 72 years). Endoscopic resection and SR were performed in 16 and 41 patients, respectively. Nine patients were diagnosed with metastasis: five who underwent SR showed pathologically confirmed lymph node metastasis in the surgical specimens, and four experienced recurrences during a median follow-up of 48 months. Univariate analyses showed that tumor thickness was significantly associated with metastasis (P = 0.021), and the vertical depth of SM invasion (P = 0.48) and depth of invasion (P = 0.38) were not. Furthermore, in multivariate analysis, tumor thickness ≥2800 μm (odds ratio, 38.70; P = 0.013) was a significant predictor for metastasis. Tumor thickness may be a more convenient and useful predictor of metastasis in patients with pT1b-SM AEG than the vertical depth of SM invasion.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally invasive vs open vs hybrid esophagectomy for esophageal cancer: a systematic review and network meta-analysis. 食管癌微创食管切除术与开放式食管切除术与混合式食管切除术：系统综述与网络荟萃分析。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae086

Andrew Patton, Matthew G Davey, Eogháin Quinn, Ciaran Reinhardt, William B Robb, Noel E Donlon

{"title":"Minimally invasive vs open vs hybrid esophagectomy for esophageal cancer: a systematic review and network meta-analysis.","authors":"Andrew Patton, Matthew G Davey, Eogháin Quinn, Ciaran Reinhardt, William B Robb, Noel E Donlon","doi":"10.1093/dote/doae086","DOIUrl":"10.1093/dote/doae086","url":null,"abstract":"Robot-assisted minimally invasive esophagectomy (RAMIE) for esophageal carcinoma has emerged as the contemporary alternative to conventional laparoscopic minimally invasive (LMIE), hybrid (HE) and open (OE) surgical approaches. No single study has compared all four approaches with a view to postoperative outcomes. A systematic search of electronic databases was undertaken. A network meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-network meta-analysis guidelines. Statistical analysis was performed using R and Shiny. Seven randomised controlled trials (RCTs) with 1063 patients were included. Overall, 32.9% of patients underwent OE (350/1063), 11.0% underwent HE (117/1063), 34.0% of patients underwent LMIE (361/1063), and 22.1% of patients underwent RAMIE (235/1063). OE had the lowest anastomotic leak rate 7.7% (27/350), while LMIE had the lowest pulmonary 10.8% (39/361), cardiac 0.56% (1/177) complications, re-intervention rates 5.08% (12/236), 90-day mortality 1.05% (2/191), and shortest length of hospital stay (mean 11.25 days). RAMIE displayed the lowest 30-day mortality rate at 0.80% (2/250). There was a significant increase in pulmonary complications for those undergoing OE (OR 3.63 [95% confidence interval: 1.4-9.77]) when compared to RAMIE. LMIE is a safe and feasible option for esophagectomy when compared to OE and HE. The upcoming RCTs will provide further data to make a more robust interrogation of the surgical outcomes following RAMIE compared to conventional open surgery to determine equipoise or superiority of each approach as the era of minimally invasive esophagectomy continues to evolve (International Prospective Register of Systematic Reviews Registration: CRD42023438790).","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

International Society for Diseases of the Esophagus consensus on management of the failed fundoplication. 国际食道疾病学会就胃底折叠术失败的处理方法达成共识。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae090

Geoffrey P Kohn, Cesare Hassan, Edward Lin, Yu-Hong Ian Wong, Sergey Morozov, Sumeet Mittal, Sarah K Thompson, Chelsea Lin, David Chen, Jordi Elliott, Varun Jahagirdar, Natasha Newman, Rippan Shukla, Peter Siersema, Giovanni Zaninotto, Ewen A Griffiths, Bas P Wijnhoven

{"title":"International Society for Diseases of the Esophagus consensus on management of the failed fundoplication.","authors":"Geoffrey P Kohn, Cesare Hassan, Edward Lin, Yu-Hong Ian Wong, Sergey Morozov, Sumeet Mittal, Sarah K Thompson, Chelsea Lin, David Chen, Jordi Elliott, Varun Jahagirdar, Natasha Newman, Rippan Shukla, Peter Siersema, Giovanni Zaninotto, Ewen A Griffiths, Bas P Wijnhoven","doi":"10.1093/dote/doae090","DOIUrl":"10.1093/dote/doae090","url":null,"abstract":"Fundoplication is a durable, effective, and well-accepted treatment for gastroesophageal reflux disease. Nonetheless, troublesome postoperative symptoms do occasionally occur with management varying widely among centers. In an attempt to standardize definition and management of postfundoplication symptoms, a panel of international experts convened by the Guidelines Committee of the International Society for Diseases of the Esophagus devised a list of 33 statements across 5 domains through a Delphi approach, with at least 80% agreement to establish consensus. Eight statements were endorsed for the domain of Definitions, four for the domain of Investigations, nine for Dysphagia, nine for Heartburn, and four for Revisional surgery. This consensus defined as the treatment goal of fundoplication the resolution of symptoms rather than normalization of physiology or anatomy. Required investigations of all symptomatic postfundoplication patients were outlined. Further management was standardized by patients' symptomatology. The appropriateness of revisional fundoplication and the techniques thereof were described and the role of revisional surgery for therapies other than fundoplication were assessed. Fundoplication remains a frequently-performed operation, and this is the first international consensus on the management of various postfundoplication problems.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hinotori™ robotic esophagectomy: a feasibility cadaver study. Hinotori™ 机器人食管切除术：一项尸体可行性研究。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae091

Vladimir J Lozanovski, Edin Hadzijusufovic, Christoph Wandhoefer, Suzanne Gisbertz, Hauke Lang, Peter P Grimminger

{"title":"Hinotori™ robotic esophagectomy: a feasibility cadaver study.","authors":"Vladimir J Lozanovski, Edin Hadzijusufovic, Christoph Wandhoefer, Suzanne Gisbertz, Hauke Lang, Peter P Grimminger","doi":"10.1093/dote/doae091","DOIUrl":"10.1093/dote/doae091","url":null,"abstract":"This preclinical feasibility study investigates the potential of utilizing the hinotori™ robot system for esophagectomy. In three human cadaver models, the esophagus was successfully mobilized and resected using the hinotori™ system, with a mean thoracic procedure time of 57 minutes. The system allowed for precise dissection and radical lymphadenectomy without arm collision, attributed to its versatile design and docking-free trocars. Standard robot-specific patient positioning, including a 35° left lateral inclination, and trocar placement in a posterior axillary line configuration were employed. Notably, trocars suitable for both laparoscopy and the hinotori™ robot were utilized, providing flexibility in trocar selection. Unique features, such as the ergonomic console and pointer-based pivot point identification system, contributed to procedural success. While these findings highlight the promising potential of the hinotori™ system in advancing esophageal surgery, further clinical studies are warranted to validate its reproducibility and clinical utility. Additionally, enhancements to the pivot point identification system and evaluation of the arm base's features may further optimize surgical outcomes.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complete pathologic response in esophageal adenocarcinoma: does it make a difference? 食管腺癌的完全病理反应：有区别吗？

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-11-28 DOI: 10.1093/dote/doae068

Britton B Donato, Megan E Campany, Justin T Brady, J Asher Jenkins, Valerie Armstrong, Richard Butterfield, Pedro Reck Dos Santos, Jonathan D'Cunha

{"title":"Complete pathologic response in esophageal adenocarcinoma: does it make a difference?","authors":"Britton B Donato, Megan E Campany, Justin T Brady, J Asher Jenkins, Valerie Armstrong, Richard Butterfield, Pedro Reck Dos Santos, Jonathan D'Cunha","doi":"10.1093/dote/doae068","DOIUrl":"10.1093/dote/doae068","url":null,"abstract":"Advancements in neoadjuvant regimens for esophageal adenocarcinoma have enabled some patients to achieve complete pathologic response at time of esophagectomy. There are currently limited data detailing this trend or the implications of complete pathologic response on survival. The National Cancer Database was used to identify 16,169 patients with esophageal adenocarcinoma that received trimodal therapy including esophagectomy between 2006 and 2020. Of these, 11.4% had complete pathologic response at esophagectomy. Patient factors, staging characteristics, and survival trends were evaluated. In patients diagnosed between 2016 and 2020, the rate of complete pathologic response was 17.5%. Female sex (OR 1.295, 95% CI 1.134-1.481, p = 0.0001), Black race (OR 1.729, 95% CI 1.362-2.196, p = 0.0002), Hispanic ethnicity (OR 1.418, 95% CI 1.073-1.875, p = 0.0141), and later era of diagnosis (2016-2020 OR 2.898, 95% CI 2.508-3.349, p < 0.0001) were independent predictors of complete pathologic response. Clinical stage II disease was associated with an increased probability of complete pathologic response (OR 1.492, 95% CI 1.19-1.871) while clinical stage III disease had a decreased probability of complete pathologic response (OR 0.762, 95% CI 0.621-0.936, p < 0.0001). Complete pathologic response conveyed a strong survival benefit, with a median survival of 86.4 months (95% CI 73.9-102.1) versus 30.7 months (95% CI 29.8-31.7, p < 0.0001) in those without complete pathologic response. Four-year median survival was also higher in those with complete pathologic response (63.3%, 95% CI 60.8-66.0% vs. 39.2%, 95% CI 38.4-40.1%, p < 0.0001). In summary, complete pathologic response is associated with a profound survival advantage in patients with esophageal adenocarcinoma. Such knowledge carries implications for patient counseling, prognostication, and surveillance and demonstrates a need for improved identification of complete clinical response prior to esophagectomy.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing the outcomes of posterior thoracic para-aortic lymph node dissection after induction chemotherapy in patients with esophageal squamous cell carcinoma. 评估食管鳞状细胞癌患者诱导化疗后胸主动脉旁淋巴结清扫术的疗效。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-10-28 DOI: 10.1093/dote/doae060

Takashi Shigeno, Mayuko Otomo, Daisuke Kajiyama, Kazuma Sato, Naoto Fujiwara, Yusuke Kinugasa, Hiroyuki Daiko, Takeo Fujita

{"title":"Assessing the outcomes of posterior thoracic para-aortic lymph node dissection after induction chemotherapy in patients with esophageal squamous cell carcinoma.","authors":"Takashi Shigeno, Mayuko Otomo, Daisuke Kajiyama, Kazuma Sato, Naoto Fujiwara, Yusuke Kinugasa, Hiroyuki Daiko, Takeo Fujita","doi":"10.1093/dote/doae060","DOIUrl":"10.1093/dote/doae060","url":null,"abstract":"Posterior thoracic para-aortic lymph node (TPAN) metastasis is a distant metastasis of esophageal cancer. Several case reports have shown that radical esophagectomy and lymphadenectomy for posterior TPAN improve the prognosis of patients with cStage IVB esophageal cancer and solitary posterior TPAN metastasis; however, the true value of this procedure is unclear. The primary objective of this study was to evaluate the short- and long-term outcomes of lymphadenectomy for posterior TPAN after induction chemotherapy in esophageal cancer. This study enrolled 15 patients who underwent radical esophagectomy for cStage IVB esophageal cancer with solitary posterior TPAN metastasis after induction chemotherapy between January 2013 and October 2022 at our hospital. The short- and long-term of radical esophagectomy and lymphadenectomy for posterior TPAN were retrospectively evaluated. All patients who underwent radical esophagectomy and lymphadenectomy for posterior TPAN achieved a pR0 in this study. The median operative time and intraoperative blood loss were 385 minutes and 164 ml, respectively. Four patients (26.7%) had postoperative complications of Clavien-Dindo grade II or more. The median postoperative hospital stay was 15 days. The 5-year overall survival and recurrence-free survival rates were 55.6% (95% confidence interval: 23.1-79.0) and 55.0% (95% confidence interval: 25.3-77.2), respectively. We showed that lymphadenectomy for posterior TPAN metastasis was associated with an improved prognosis of some patients with advanced esophageal cancer. This technique may serve as a viable treatment option for patients who respond well to induction chemotherapy.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Esophagectomy after definitive chemoradiation in esophageal cancer: a safe therapeutic strategy. 食管癌明确化疗后的食管切除术：一种安全的治疗策略。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2024-10-28 DOI: 10.1093/dote/doae059

Eline G M van Geffen, Karen J Neelis, Hein Putter, Marije Slingerland, Wobbe O de Steur, Jolein van der Kraan, Aart J van der Molen, A Stijn L P Crobach, Henk H Hartgrink

{"title":"Esophagectomy after definitive chemoradiation in esophageal cancer: a safe therapeutic strategy.","authors":"Eline G M van Geffen, Karen J Neelis, Hein Putter, Marije Slingerland, Wobbe O de Steur, Jolein van der Kraan, Aart J van der Molen, A Stijn L P Crobach, Henk H Hartgrink","doi":"10.1093/dote/doae059","DOIUrl":"10.1093/dote/doae059","url":null,"abstract":"The standard treatment regimen for esophageal cancer is chemoradiation followed by esophagectomy. However, the use of neoadjuvant chemoradiotherapy damages the surrounding tissue, which potentially increases the risk of postoperative complications, including anastomotic leakage. The impact of definitive chemoradiotherapy (dCRT, 50.4 Gy radiotherapy) compared to the standard neoadjuvant scheme (nCRT, 41.4 Gy radiotherapy) prior to surgery on the incidence of anastomotic leakage remains poorly understood. To study this, all patients who received dCRT between 2011 and 2021 followed by esophagectomy were included. For each patient, two patients who received nCRT were selected as matched controls. Outcomes included postoperative anastomotic leakage, pulmonary and other complications, anastomotic stenosis, pulmonary and other postoperative complications (Clavien Dindo Classification ≥1), and overall survival. One hundred and eight patients were included with a median follow-up of 28 months. The time between neoadjuvant treatment and surgery was longer in the dCRT group compared to the nCRT group (65 vs. 48 days, P < 0.001). Postoperatively, significantly more patients in the dCRT group suffered from anastomotic leakage (11% vs. 1%, P = 0.04) and anastomotic stenosis (42% vs. 17%, P < 0.01). No differences were found for other complications or overall survival between both groups. In conclusion, preoperative dCRT is associated with a higher risk of anastomotic leakage and stenosis. These complications, however, can be treated effectively. Therefore, esophagectomy after dCRT is considered to be an appropriate treatment strategy in a selected patient group.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0