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What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy

Standard

What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy. / Kutup, Asad; Nentwich, Michael F; Bollschweiler, Elfriede; Bogoevski, Dean; Izbicki, Jakob R; Hölscher, Arnulf H.

in: ANN SURG, Jahrgang 260, Nr. 6, 01.12.2014, S. 1016-1022.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Kutup, A, Nentwich, MF, Bollschweiler, E, Bogoevski, D, Izbicki, JR & Hölscher, AH 2014, 'What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy', ANN SURG, Jg. 260, Nr. 6, S. 1016-1022. https://doi.org/10.1097/SLA.0000000000000335

APA

Kutup, A., Nentwich, M. F., Bollschweiler, E., Bogoevski, D., Izbicki, J. R., & Hölscher, A. H. (2014). What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy. ANN SURG, 260(6), 1016-1022. https://doi.org/10.1097/SLA.0000000000000335

Vancouver

Kutup A, Nentwich MF, Bollschweiler E, Bogoevski D, Izbicki JR, Hölscher AH. What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy. ANN SURG. 2014 Dez 1;260(6):1016-1022. https://doi.org/10.1097/SLA.0000000000000335

Bibtex

@article{b3dfab7f509d425d8a0654eb18163ce4,
title = "What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy",
abstract = "OBJECTIVE: To analyze survival differences between transthoracic esophagectomy (TTE) and limited transhiatal esophagectomy (THE) in clinically (cT3) and pathologically (pT3) staged advanced tumors without neoadjuvant treatment.BACKGROUND: Debate exists whether in the type of resection in locally advanced cancer plays a role in prognosis and whether THE is a valuable alternative to TTE regarding oncological doctrine and overall survival.METHODS: In a retrospective study of 2 high-volume centers, 468 patients with cT3NXM0 esophageal cancer, including 242 (51.7%) squamous cell carcinomas (SCCs) and 226 (48.3%) adenocarcinomas (ACs), were analyzed. A total of 341 (72.9%) TTE and 127 (27.1%) THE were performed. We used the propensity score matching to build comparable groups. Primary endpoint was the overall survival; secondary endpoints included resection status and lymph node yield.RESULTS: TTE achieved a higher rate of R0 resections (86.2% vs 73.2%; P = 0.001) and a higher median lymph node yield (27.0 ± 12.4 vs 17.0 ± 6.4; P < 0.001) than THE. Thirty-day mortality rate was 6.6% (8/121) for TTE and 7.4% (9/121) for THE (P = 0.600). In the matched groups, TTE was beneficial for pT3 SCC (P = 0.004), pT3 AC (P = 0.029), cT3 SCC (P = 0.018), and cT3 AC (P = 0.028) patients. TTE was either beneficial in pN2 disease for cT3 AC + SCC or pT3 SCC but not for pT3 AC patients, without nodal stratification in pT3 and cT3 SCC node-positive patients. On multivariable analysis, TTE remained an independent factor for survival.CONCLUSIONS: Extended TTE achieved a higher rate of R0 resections, a higher lymph node yield, and resulted in a prolonged survival than THE in pT3, cT3, and node-positive patients.",
keywords = "Adult, Aged, Aged, 80 and over, Endoscopy, Gastrointestinal, Esophageal Neoplasms, Esophagectomy, Female, Follow-Up Studies, Germany, Humans, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Survival Rate, Thoracotomy, Time Factors, Treatment Outcome",
author = "Asad Kutup and Nentwich, {Michael F} and Elfriede Bollschweiler and Dean Bogoevski and Izbicki, {Jakob R} and H{\"o}lscher, {Arnulf H}",
year = "2014",
month = dec,
day = "1",
doi = "10.1097/SLA.0000000000000335",
language = "English",
volume = "260",
pages = "1016--1022",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

RIS

TY - JOUR

T1 - What should be the gold standard for the surgical component in the treatment of locally advanced esophageal cancer: transthoracic versus transhiatal esophagectomy

AU - Kutup, Asad

AU - Nentwich, Michael F

AU - Bollschweiler, Elfriede

AU - Bogoevski, Dean

AU - Izbicki, Jakob R

AU - Hölscher, Arnulf H

PY - 2014/12/1

Y1 - 2014/12/1

N2 - OBJECTIVE: To analyze survival differences between transthoracic esophagectomy (TTE) and limited transhiatal esophagectomy (THE) in clinically (cT3) and pathologically (pT3) staged advanced tumors without neoadjuvant treatment.BACKGROUND: Debate exists whether in the type of resection in locally advanced cancer plays a role in prognosis and whether THE is a valuable alternative to TTE regarding oncological doctrine and overall survival.METHODS: In a retrospective study of 2 high-volume centers, 468 patients with cT3NXM0 esophageal cancer, including 242 (51.7%) squamous cell carcinomas (SCCs) and 226 (48.3%) adenocarcinomas (ACs), were analyzed. A total of 341 (72.9%) TTE and 127 (27.1%) THE were performed. We used the propensity score matching to build comparable groups. Primary endpoint was the overall survival; secondary endpoints included resection status and lymph node yield.RESULTS: TTE achieved a higher rate of R0 resections (86.2% vs 73.2%; P = 0.001) and a higher median lymph node yield (27.0 ± 12.4 vs 17.0 ± 6.4; P < 0.001) than THE. Thirty-day mortality rate was 6.6% (8/121) for TTE and 7.4% (9/121) for THE (P = 0.600). In the matched groups, TTE was beneficial for pT3 SCC (P = 0.004), pT3 AC (P = 0.029), cT3 SCC (P = 0.018), and cT3 AC (P = 0.028) patients. TTE was either beneficial in pN2 disease for cT3 AC + SCC or pT3 SCC but not for pT3 AC patients, without nodal stratification in pT3 and cT3 SCC node-positive patients. On multivariable analysis, TTE remained an independent factor for survival.CONCLUSIONS: Extended TTE achieved a higher rate of R0 resections, a higher lymph node yield, and resulted in a prolonged survival than THE in pT3, cT3, and node-positive patients.

AB - OBJECTIVE: To analyze survival differences between transthoracic esophagectomy (TTE) and limited transhiatal esophagectomy (THE) in clinically (cT3) and pathologically (pT3) staged advanced tumors without neoadjuvant treatment.BACKGROUND: Debate exists whether in the type of resection in locally advanced cancer plays a role in prognosis and whether THE is a valuable alternative to TTE regarding oncological doctrine and overall survival.METHODS: In a retrospective study of 2 high-volume centers, 468 patients with cT3NXM0 esophageal cancer, including 242 (51.7%) squamous cell carcinomas (SCCs) and 226 (48.3%) adenocarcinomas (ACs), were analyzed. A total of 341 (72.9%) TTE and 127 (27.1%) THE were performed. We used the propensity score matching to build comparable groups. Primary endpoint was the overall survival; secondary endpoints included resection status and lymph node yield.RESULTS: TTE achieved a higher rate of R0 resections (86.2% vs 73.2%; P = 0.001) and a higher median lymph node yield (27.0 ± 12.4 vs 17.0 ± 6.4; P < 0.001) than THE. Thirty-day mortality rate was 6.6% (8/121) for TTE and 7.4% (9/121) for THE (P = 0.600). In the matched groups, TTE was beneficial for pT3 SCC (P = 0.004), pT3 AC (P = 0.029), cT3 SCC (P = 0.018), and cT3 AC (P = 0.028) patients. TTE was either beneficial in pN2 disease for cT3 AC + SCC or pT3 SCC but not for pT3 AC patients, without nodal stratification in pT3 and cT3 SCC node-positive patients. On multivariable analysis, TTE remained an independent factor for survival.CONCLUSIONS: Extended TTE achieved a higher rate of R0 resections, a higher lymph node yield, and resulted in a prolonged survival than THE in pT3, cT3, and node-positive patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Endoscopy, Gastrointestinal

KW - Esophageal Neoplasms

KW - Esophagectomy

KW - Female

KW - Follow-Up Studies

KW - Germany

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Retrospective Studies

KW - Survival Rate

KW - Thoracotomy

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1097/SLA.0000000000000335

DO - 10.1097/SLA.0000000000000335

M3 - SCORING: Journal article

C2 - 24950288

VL - 260

SP - 1016

EP - 1022

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 6

ER -