OBJECTIVE: To assess the incidence of anastomotic recurrence of oesophageal carcinoma and its relationship with proximal surgical margin invaded by tumour. DESIGN: Retrospective study. SETTING: National Cancer Center, Tokyo. SUBJECTS: 463 patients with thoracic oesophageal squamous carcinoma who underwent transthoracic oesophagectomy with a minimal follow-up of three years. MAIN OUTCOME MEASURES: Proximal surgical margin, anastomotic recurrence rate, prognosis. RESULTS: Anastomotic recurrence developed in 12 of the 463 patients (3%), 10 of whom had histologically clear surgical margins. Sixteen patients had histologically invaded surgical margins, 13 of whom developed recurrent disease, 2 (13%) at the anastomosis. These 2 patients died of other diseases after treatment for their recurrent tumours. Two patients with anastomotic recurrence lived for over 5 years without signs of disease after excision of the recurrent tumour. Necropsy of 47 patients with recurrent tumors showed that only one (2%) was at the anastomosis. CONCLUSIONS: Anastomotic recurrence was not inevitable and was rarely fatal in patients with invaded proximal surgical margins at transthoracic oesophagectomy. However, although infrequent, it did occur, even in patients with a cancer-free surgical margin. Resection may be indicated for patients with anastomotic recurrence and no other signs of metastases.
OBJECTIVE: To assess the incidence of anastomotic recurrence of oesophageal carcinoma and its relationship with proximal surgical margin invaded by tumour. DESIGN: Retrospective study. SETTING: National Cancer Center, Tokyo. SUBJECTS: 463 patients with thoracic oesophageal squamous carcinoma who underwent transthoracic oesophagectomy with a minimal follow-up of three years. MAIN OUTCOME MEASURES: Proximal surgical margin, anastomotic recurrence rate, prognosis. RESULTS: Anastomotic recurrence developed in 12 of the 463 patients (3%), 10 of whom had histologically clear surgical margins. Sixteen patients had histologically invaded surgical margins, 13 of whom developed recurrent disease, 2 (13%) at the anastomosis. These 2 patients died of other diseases after treatment for their recurrent tumours. Two patients with anastomotic recurrence lived for over 5 years without signs of disease after excision of the recurrent tumour. Necropsy of 47 patients with recurrent tumors showed that only one (2%) was at the anastomosis. CONCLUSIONS: Anastomotic recurrence was not inevitable and was rarely fatal in patients with invaded proximal surgical margins at transthoracic oesophagectomy. However, although infrequent, it did occur, even in patients with a cancer-free surgical margin. Resection may be indicated for patients with anastomotic recurrence and no other signs of metastases.
Authors: Andrew P Barbour; Nabil P Rizk; Mithat Gonen; Laura Tang; Manjit S Bains; Valerie W Rusch; Daniel G Coit; Murray F Brennan Journal: Ann Surg Date: 2007-07 Impact factor: 12.969
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Authors: E Yu; P Tai; J Younus; R Malthaner; P Truong; L Stitt; G Rodrigues; R Ash; R Dar; B Yaremko; A Tomiak; B Dingle; M Sanatani; M Vincent; W Kocha; D Fortin; R Inculet Journal: Curr Oncol Date: 2009-08 Impact factor: 3.677
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