BACKGROUND: Overall survival in patients who underwent transhiatal esophagectomy submitted or not to neoadjuvant therapy. Southern Brazil has one of the highest incidences of esophageal squamous cell carcinoma in the world. Transthoracic esophagectomy allows more complete abdominal and thoracic lymphadenectomy than transhiatal. However, this one is associated with less morbidity. AIM: To analyze the outcomes and prognostic factors of squamous esophageal cancer treated with transhiatal procedure. METHODS: All patients selected for transhiatal approach were included as a potentially curative treatment and overall survival, operative time, lymph node analysis and use of neoadjuvant therapy were analyzed. RESULTS: A total of 96 patients were evaluated. The overall 5-year survival was 41.2%. Multivariate analysis showed that operative time and presence of positive lymph nodes were both associated with a worse outcome, while neoadjuvant therapy was associated with better outcome. The negative lymph-node group had a 5-year survival rate of 50.2%. CONCLUSION: Transhiatal esophagectomy can be safely used in patients with malnutrition degree that allows the procedure, in those with associated respiratory disorders and in the elderly. It provides considerable long-term survival, especially in the absence of metastases to local lymph nodes. The wider use of neoadjuvant therapy has the potential to further increase long-term survival.
BACKGROUND: Overall survival in patients who underwent transhiatal esophagectomy submitted or not to neoadjuvant therapy. Southern Brazil has one of the highest incidences of esophageal squamous cell carcinoma in the world. Transthoracic esophagectomy allows more complete abdominal and thoracic lymphadenectomy than transhiatal. However, this one is associated with less morbidity. AIM: To analyze the outcomes and prognostic factors of squamous esophageal cancer treated with transhiatal procedure. METHODS: All patients selected for transhiatal approach were included as a potentially curative treatment and overall survival, operative time, lymph node analysis and use of neoadjuvant therapy were analyzed. RESULTS: A total of 96 patients were evaluated. The overall 5-year survival was 41.2%. Multivariate analysis showed that operative time and presence of positive lymph nodes were both associated with a worse outcome, while neoadjuvant therapy was associated with better outcome. The negative lymph-node group had a 5-year survival rate of 50.2%. CONCLUSION: Transhiatal esophagectomy can be safely used in patients with malnutrition degree that allows the procedure, in those with associated respiratory disorders and in the elderly. It provides considerable long-term survival, especially in the absence of metastases to local lymph nodes. The wider use of neoadjuvant therapy has the potential to further increase long-term survival.
Authors: Asad Kutup; Michael F Nentwich; Elfriede Bollschweiler; Dean Bogoevski; Jakob R Izbicki; Arnulf H Hölscher Journal: Ann Surg Date: 2014-12 Impact factor: 12.969
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Authors: Dean Bogoevski; Maximilian Bockhorn; Alexandra Koenig; Matthias Reeh; Katharina von Loga; Guido Sauter; Thomas Rösch; Jakob R Izbicki Journal: World J Surg Date: 2011-06 Impact factor: 3.352
Authors: Marilisa Ferruda Andreoli Risso; Luigi Carlo da Silva Costa; Valdir Tercioti; José Antonio Possatto Ferrer; Luiz Roberto Lopes; Nelson Adami Andreollo Journal: Arq Bras Cir Dig Date: 2022-06-24