AIMS: Positive microscopic margins after major cancer surgery adversely affect prognosis. We questioned whether the benefit of a multimodal approach in oesophageal carcinoma is due to reduced resection margin involvement and whether multimodal therapy alters the disease course when margins are involved. METHODS: Pathology specimens of 212 patients, treated with either multimodal therapy or surgery alone, were re-reviewed to assess margin involvement by tumour. Margin status was compared with recurrence and survival data. RESULTS: Margin involvement was decreased with multimodal therapy (16 of 103 patients) vs surgery (33 of 109 patients), associated with reduced tumour recurrence and a significant survival advantage. However, even with involved margins, multimodal therapy had lower recurrence vs surgery and a small survival benefit. CONCLUSIONS: Multimodal therapy significantly reduces margin involvement. The benefit of multimodal therapy remains highly significant for patients with clear margins. This study confirms for oesophageal carcinoma the value of an aggressive surgical approach in achieving negative resection margins.
AIMS: Positive microscopic margins after major cancer surgery adversely affect prognosis. We questioned whether the benefit of a multimodal approach in oesophageal carcinoma is due to reduced resection margin involvement and whether multimodal therapy alters the disease course when margins are involved. METHODS: Pathology specimens of 212 patients, treated with either multimodal therapy or surgery alone, were re-reviewed to assess margin involvement by tumour. Margin status was compared with recurrence and survival data. RESULTS: Margin involvement was decreased with multimodal therapy (16 of 103 patients) vs surgery (33 of 109 patients), associated with reduced tumour recurrence and a significant survival advantage. However, even with involved margins, multimodal therapy had lower recurrence vs surgery and a small survival benefit. CONCLUSIONS: Multimodal therapy significantly reduces margin involvement. The benefit of multimodal therapy remains highly significant for patients with clear margins. This study confirms for oesophageal carcinoma the value of an aggressive surgical approach in achieving negative resection margins.
Authors: Sanghyuk Song; Eui Kyu Chie; Hak Jae Kim; Chang-Hyun Kang; Young Tae Kim; Joo Hyun Kim; Charn Il Park Journal: Cancer Res Treat Date: 2013-09-30 Impact factor: 4.679
Authors: Bareld B Pultrum; Judith Honing; Justin K Smit; Hendrik M van Dullemen; Gooitzen M van Dam; Henk Groen; Harry Hollema; John Th M Plukker Journal: Ann Surg Oncol Date: 2010-03 Impact factor: 5.344
Authors: L van de Schoot; E A P M Romme; M J van der Sangen; G J Creemers; G van Lijnschoten; O J Repelaer van Driel; H J T Rutten; G A P Nieuwenhuijzen Journal: Ann Surg Oncol Date: 2007-09-26 Impact factor: 5.344