HYPOTHESIS: Extended lymphadenectomy in gastroesphageal cancer leads to improved long-term survival without compromising postoperative outcomes in Western patients to attain the standard achieved in Japanese centers. DESIGN: Cohort study comparing postoperative outcomes and long-term survival with data from the National Cancer Center (NCC) of Tokyo, Japan. Outcomes were also compared with data from the UK National Oesophago-Gastric Cancer Audit (NOGCA) and a representative cohort from southeast England. Prospectively collected data were independently audited. SETTING: University medical center. PATIENTS: From 2003 to 2010, 100 patients underwent gastrectomy and 109 underwent esophagectomy. MAIN OUTCOME MEASURES: Postoperative mortality and morbidity and long-term overall survival. Lymph node count was used as a measure for the extent of lymphadenectomy. RESULTS: One death occurred after esophagectomy and none after gastrectomy. Anastomotic leak rate was approximately 2% in both cohorts. Kaplan-Meier estimates of 5-year overall survival after gastrectomy and esophagectomy were 58.4% and 47.8%, respectively. Postoperative mortality and technical complications for gastric and esophageal cancer resections were similar to NCC rates (P = .20). Stage for stage 5-year survival rates in patients with esophageal cancer and stages II and III gastric cancer were similar to outcomes in the NCC. The 5-year survival for patients with gastric cancer was worse for those with stage I (P < .001) and better for those with stage IV (P < .001) disease compared with NCC rates. Postoperative outcomes and long-term survival were significantly better than those reported by the NOGCA and the data from the southeast of England (P < .05). CONCLUSIONS: This study demonstrates that postoperative outcomes and long-term survival after gastroesophageal cancer resection can be improved in Western patients to the highest standard achieved in Japan.
HYPOTHESIS: Extended lymphadenectomy in gastroesphageal cancer leads to improved long-term survival without compromising postoperative outcomes in Western patients to attain the standard achieved in Japanese centers. DESIGN: Cohort study comparing postoperative outcomes and long-term survival with data from the National Cancer Center (NCC) of Tokyo, Japan. Outcomes were also compared with data from the UK National Oesophago-Gastric Cancer Audit (NOGCA) and a representative cohort from southeast England. Prospectively collected data were independently audited. SETTING: University medical center. PATIENTS: From 2003 to 2010, 100 patients underwent gastrectomy and 109 underwent esophagectomy. MAIN OUTCOME MEASURES: Postoperative mortality and morbidity and long-term overall survival. Lymph node count was used as a measure for the extent of lymphadenectomy. RESULTS: One death occurred after esophagectomy and none after gastrectomy. Anastomotic leak rate was approximately 2% in both cohorts. Kaplan-Meier estimates of 5-year overall survival after gastrectomy and esophagectomy were 58.4% and 47.8%, respectively. Postoperative mortality and technical complications for gastric and esophageal cancer resections were similar to NCC rates (P = .20). Stage for stage 5-year survival rates in patients with esophageal cancer and stages II and III gastric cancer were similar to outcomes in the NCC. The 5-year survival for patients with gastric cancer was worse for those with stage I (P < .001) and better for those with stage IV (P < .001) disease compared with NCC rates. Postoperative outcomes and long-term survival were significantly better than those reported by the NOGCA and the data from the southeast of England (P < .05). CONCLUSIONS: This study demonstrates that postoperative outcomes and long-term survival after gastroesophageal cancer resection can be improved in Western patients to the highest standard achieved in Japan.
Authors: Ravikrishna Mamidanna; Alex M Almoudaris; Alex Bottle; Paul Aylin; Omar Faiz; George B Hanna Journal: Surg Endosc Date: 2013-04-24 Impact factor: 4.584
Authors: Humair S Quadri; Brandon G Smaglo; Shannon J Morales; Anna Chloe Phillips; Aimee D Martin; Walid M Chalhoub; Nadim G Haddad; Keith R Unger; Angela D Levy; Waddah B Al-Refaie Journal: Front Surg Date: 2017-08-03
Authors: Young-Woo Kim; Jungnam Joo; Hong Man Yoon; Bang Wool Eom; Keun Won Ryu; Il Ju Choi; Myeong Cherl Kook; Christoph Schuhmacher; Joerg Ruediger Siewert; Daniel Reim Journal: Medicine (Baltimore) Date: 2016-07 Impact factor: 1.889