Y-S Mao1, S-G Gao1, Q Wang2, X-T Shi3, Y Li4, W-J Gao5, F-S Guan6, X F Li7, Y-T Han8, Y-Y Liu9, J-F Liu10, K Zhang11, S-Y Liu12, X-N Fu13, W-T Fang14, L-Q Chen15, Q-C Wu16, G-M Xiao17, K-N Chen18, G-G Jiao19, J-H Luo20, W-M Mao21, T-H Rong22, J-H Fu22, L-J Tang2, C Chen23, S-D Xu24, S-P Guo25, Z-T Yu26, J Hu27, Z-D Hu28, A Sihoe29, Y-K Yang1, N-N Ding1, D Yang1, Y-B Gao1, J He1. 1. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital，Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Department of Thoracic Surgery, Zhongshang Hospital, Fudan University, Shanghai; China. 3. Department of Thoracic Surgery, Anyang Cancer Hospital, Anyang, China. 4. Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou, China. 5. Department of Thoracic Surgery, Linxian Renmin Hospital, Linxian, China. 6. Department of Thoracic Surgery, Linxian Cancer Hospital, Linxian, China. 7. Department of Thoracic Surgery, The Fourth Military University Hospital, Xian, China. 8. Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, China. 9. Department of Thoracic Surgery, Liaoning Cancer Hospital, Shenyang, China. 10. Department of Thoracic Surgery, The Fourth Hospital, Shijiazhuan, China. 11. Department of Thoracic Surgery, Jining Medical school Hospital, Jining，China. 12. Department of Thoracic Surgery, Fujian Cancer Hospital, Fujian Medical University, Fuzhou, China. 13. Department of Thoracic Surgery, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China. 14. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, China. 15. Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, China. 16. Department of Thoracic Surgery, The First Affiliated Hospital, Zhongqing Medical University, Zhongqing, China. 17. Department of Thoracic Surgery, Hunan Cancer Hospital, Changsha, China. 18. Department of Thoracic Surgery, Beijing cancer hospital, Beijing University, Beijing, China. 19. Department of Thoracic Surgery, Linxian Esophageal Cancer Hospital, Linxian, China. 20. Department of Thoracic Surgery, Jiangsu Renmin Hospital, Nanjing, China. 21. Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, China. 22. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center; Guangzhou, China. 23. Department of Thoracic Surgery, Fujian Medical University Hospital, Fuzhou, China. 24. Department of Thoracic Surgery, Heilongjiang Cancer Hospital, Harbin, China. 25. Department of Thoracic Surgery, Shanxi Cancer Hospital, Taiyuan, China. 26. Department of Thoracic Surgery, Tianjin Cancer Hospital, Tianjin, China. 27. Department of Thoracic Surgery, First Affiliated Hospital, Zhejiang University, Hangzhou, China. 28. Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, China. 29. Department of Thoracic Surgery, Dept of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Abstract
Esophageal cancer has a high incidence among malignancies in China, but a comprehensive picture of the status of its surgical management in China has hitherto not been available. A nationwide database has recently been established to address this issue. METHOD: A National Database was setup through a network platform, and data was collected from 70 high-volume centers (>100 esophagectomies/per year) across China. Data was entered between January 2009 and December 2014, and was analyzed in June 2015 after a minimal follow-up of 6 months for all patients. 8181 patients with complete data who received surgery for primary esophageal cancer on the Database were included in the analysis. RESULT: In this series, there were 6052 males and 2129 females, with a mean age of 60.5 years (range: 22-90 years). The pathology in 95.5% of patients was squamous cell carcinoma. The pathological stage distribution was 1.2% in stage 0, 2.5% in Ia, 11.5% in Ib, 14.8% in IIa, 36.1% in IIb, 19.3% in IIIa, 8.3% in IIIb, 6.2% in IIIc. 1800 patients (22.0%) with locally advanced disease received preoperative neoadjuvant therapy and 3592 patients (43.9%) underwent postoperative adjuvant chemotherapy and/or radiotherapy. The esophagectomies were performed through left thoracotomy approach in 5870 cases (72.6%), through right chest approach in 2215 cases (27.4%) including right thoracotomy (21.3%) and VATS (6.1%). The 30-day postoperative mortality rate was 0.6% (43 patients), and the overall postoperative complication rate was 11.6% (951 patients). The 1-, 3-, and 5-year overall survival rates were 82.6%, 61.6%, and 52.9%, respectively. CONCLUSION: This National Registry Database from high-volume centers provides a comprehensive picture of surgical management for esophageal cancer in China for the first time. Squamous cell carcinoma predominates, but there is heterogeneity with respect to the surgical approach and perioperative oncologic management. Overall, surgical mortality and morbidity rates are low, and good survival rates have been achieved due to improvement of surgical treatment technology in recent years.
Esophageal cancer has a high incidence among malignancies in China, but a comprehensive picture of the status of its surgical management in China has hitherto not been available. A nationwide database has recently been established to address this issue. METHOD: A National Database was setup through a network platform, and data was collected from 70 high-volume centers (>100 esophagectomies/per year) across China. Data was entered between January 2009 and December 2014, and was analyzed in June 2015 after a minimal follow-up of 6 months for all patients. 8181 patients with complete data who received surgery for primary esophageal cancer on the Database were included in the analysis. RESULT: In this series, there were 6052 males and 2129 females, with a mean age of 60.5 years (range: 22-90 years). The pathology in 95.5% of patients was squamous cell carcinoma. The pathological stage distribution was 1.2% in stage 0, 2.5% in Ia, 11.5% in Ib, 14.8% in IIa, 36.1% in IIb, 19.3% in IIIa, 8.3% in IIIb, 6.2% in IIIc. 1800 patients (22.0%) with locally advanced disease received preoperative neoadjuvant therapy and 3592 patients (43.9%) underwent postoperative adjuvant chemotherapy and/or radiotherapy. The esophagectomies were performed through left thoracotomy approach in 5870 cases (72.6%), through right chest approach in 2215 cases (27.4%) including right thoracotomy (21.3%) and VATS (6.1%). The 30-day postoperative mortality rate was 0.6% (43 patients), and the overall postoperative complication rate was 11.6% (951 patients). The 1-, 3-, and 5-year overall survival rates were 82.6%, 61.6%, and 52.9%, respectively. CONCLUSION: This National Registry Database from high-volume centers provides a comprehensive picture of surgical management for esophageal cancer in China for the first time. Squamous cell carcinoma predominates, but there is heterogeneity with respect to the surgical approach and perioperative oncologic management. Overall, surgical mortality and morbidity rates are low, and good survival rates have been achieved due to improvement of surgical treatment technology in recent years.
Authors: Hongtao Duan; Changjian Shao; Minghong Pan; Honggang Liu; Xiaoping Dong; Yong Zhang; Liping Tong; Yingtong Feng; Yuanyuan Wang; Lu Wang; Neil B Newman; Inderpal S Sarkaria; John V Reynolds; Francesco De Cobelli; Zhiqiang Ma; Tao Jiang; Xiaolong Yan Journal: Front Immunol Date: 2022-06-02 Impact factor: 8.786