Comparison of Open and Thoracoscopic Esophagectomy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma After Neoadjuvant Therapy

Hamai, Yoichi; Emi, Manabu; Ibuki, Yuta; Kurokáwa, Tomonori; Yoshikawa, Toru; Hirohata, Ryosuke; Ohsawa, Manato; Kitasaki, Nao; Okada, Morihito

doi:10.21873/anticanres.15083

Cited by 4 publications

(6 citation statements)

References 35 publications

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“…The reconstructed neurological function of alimentary canal losses rhythmicity and naturality [ 16 , 17 ], causing the delayed gastric emptying. As a result, the pylorospasm leads to the gastric outlet obstruction, bringing about gastrectasia and gastric retention, which aggravates the gastroesophageal reflux to some extent [ 18 , 19 ]. Among 300 patients in this study, there were 45 patients having reflux esophagitis (including symptomatic reflux and pathological reflux), with the total incidence of 15.0%.…”

Section: Discussionmentioning

confidence: 99%

A Study on Risk Factors Associated with Reflux Esophagitis in Patients Undergoing Esophageal Cancer Surgery

Wang

Liu

Wei

et al. 2022

Journal of Healthcare Engineering

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Objective. To investigate the risk factors associated with reflux esophagitis in patients undergoing esophageal cancer surgery and to provide reference for the prevention and treatment of reflux esophagitis. Methods. In the manner retrospective study, the data of 300 patients with esophageal cancer who received the surgical treatment in our hospital (January 2018–December 2020) were retrospectively reviewed. The 300 patients were divided into the occurrence group (n = 45) and nonoccurrence group (n = 255) depending on whether they had reflux esophagitis after surgery. The social demographic data and clinical data of the patients in the two groups were collected. These data were classified into the personal factors and surgical factors. The single-factor analysis method was adopted to analyze the effects of the personal and surgical factors on reflux esophagitis. The factors with statistically significant differences in the single-factor analysis were analyzed by logistic regression to verify the factors were the risk factors associated with reflux esophagitis in patients undergoing esophageal cancer surgery. Results. The differences in the bodyweight, body mass index (BMI), length of the resected esophagus, surgical approach, intraoperative blood loss, gastrointestinal decompression volume, and surgery time between the two groups were of statistical significance ( P < 0.05 ). After being tested by the logistics multivariate analysis, length of the resected esophagus, whole stomach reconstruction, intraoperative blood loss, and surgery time were identified as the risk factors associated with reflux esophagitis in patients undergoing esophageal cancer surgery. Conclusion. The length of the resected esophagus, whole stomach reconstruction, intraoperative blood loss, and surgery time were the risk factors associated with reflux esophagitis in patients undergoing esophageal cancer surgery. It is necessary to choose the appropriate surgical approach according to the patients’ conditions in practice and to strengthen the prevention and treatment of reflux esophagitis.

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Section: Discussionmentioning

confidence: 99%

A Study on Risk Factors Associated with Reflux Esophagitis in Patients Undergoing Esophageal Cancer Surgery

Wang

Liu

Wei

et al. 2022

Journal of Healthcare Engineering

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“…Excluding 67 non-neoadjuvant or single-arm studies, 6 articles remained. The 6 articles were retrospective studies, among which two were propensity score matching studies [12][13][14][15][16][17]. The literatures were evaluated according to the Newcastle-Ottawa Scale and all literatures were of medium to high quality (7-8 score, Supplementary table 1).…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive versus open esophagectomy after neoadjuvant therapy for esophageal cancer: a meta-analysis

Jin

Zhu

Sun

et al. 2022

Preprint

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Objectives: Neoadjuvant therapy and minimally invasive esophagectomy (MIE) are widely used in the comprehensive treatment of esophageal cancer. This study aimed to investigate the advantages of MIE for esophageal cancer after neoadjuvant therapy.Methods: Published clinical studies were reviewed and survival data and safety data were extracted. We compared the long-term survival and safety of MIE versus open esophagectomy after neoadjuvant surgery in a series of meta-analyses.Results: 6 retrospective studies were included. Overall, MIE could significantly improve the overall survival of patients with esophageal cancer after neoadjuvant therapy compared with open esophagectomy [hazard ratio (HR)=0.86, 95% confidence interval (CI) (0.75, 0.98)]. Compared with open esophagectomy, MIE could significantly reduce intraoperative blood loss and operative time [mean difference (MD)=-40.28.78, 95%CI (-62.98, -17.58); MD=-28.78, 95%CI (-42.48, -15.07), respectively]. There was no significant difference in 30-day and 90-day mortality between MIE and open esophagectomy [odds ratio (OR)=0.42, 95%CI (0.09, 2.01); OR=0.80, 95%CI (0.25, 2.60), respectively]. MIE could reduce the incidence of anastomotic leakage, recurrent laryngeal nerve palsy and chylothorax [OR=0.70, 95%CI (0.37, 1.32); OR=1.43, 95%CI (0.33, 6.25); HR=1.79, 95%CI (0.67, 4.75), respectively], but the incidence of pneumonia was significantly reduced [HR=0.43, 95%CI (0.22, 0.82)]. In addition, the length of hospital stay and the incidence of total complications were significantly reduced after MIE [MD=-2.61, 95%CI (-3.10,-2.12); HR=0.66, 95%CI (0.45, 0.98), respectively].Conclusion: MIE after neoadjuvant therapy is effective and safe. Compared with open esophagectomy, MIE can improve the long-term survival and reduce the incidence of postoperative complications of esophageal cancer patients.

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“…Patients with a performance status of 0 or 1 according to the Eastern Cooperative Oncology Group criteria were treated with NAC or NACRT followed by esophagectomy based on the resectability of cancer in the thoracic esophagus or esophagogastric junction (EGJ), if tumor invasion was worse than cT2, positive for LNM (cNþ) or supraclavicular LNM was resectable. [10][11][12][13][14] The clinicopathological profiles of the tumors were based on the TNM Classification of Malignant Tumors, 8th edition. 15 The patients with clinically diagnosed Stage I (cT1 N1 M0) to IVB (supraclavicular LNM, M1) ESCC before initiating treatment were included in this study.…”

Section: Patientsmentioning

confidence: 99%

“…13 NACRT comprised concurrent 40 Gy radiotherapy (20 fractions) and chemotherapy with 5-fluorouracil (5FU) and docetaxel, cisplatin, or a combination of both, as previously described. 10,13,14 NAC comprised the cisplatin/5FU, nedaplatin/5FU, or docetaxel/cisplatin/5FU regimens as previously described. [11][12][13]…”

Section: Neoadjuvant Therapymentioning

confidence: 99%

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Prognostic factors for esophageal squamous cell carcinoma without pathological lymph node metastasis after neoadjuvant therapy and surgery

Hamai,

Emi,

Ibuki

et al. 2023

World j. surg.

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BackgroundPathological lymph node metastasis (LNM) following multimodal therapy is an important indicator of poor prognosis in patients with esophageal cancer. However, a significant number of patients without LNM are still at high risk for recurrence.MethodsWe assessed prognostic factors in 143 patients without pathological LNM who were diagnosed with locally advanced esophageal squamous cell carcinoma (ESCC) and underwent neoadjuvant chemotherapy (NAC) or chemoradiotherapy (NACRT), followed by surgery.ResultsUsing univariate and multivariate analyses of recurrence‐free survival, carcinoembryonic antigen (CEA) levels (hazard ratio [HR]: 2.17, 95% confidence interval [CI]: 1.12–4.23, and p = 0.02) and neutrophil‐to‐lymphocyte ratio (NLR) (HR: 1.22, 95% CI: 1.04–1.43, and p = 0.02) were significant independent covariates. Furthermore, pretherapeutic LNM (HR: 1.94, 95% CI: 1.003–3.76, and p = 0.049), NACRT (HR: 3.29, 95% CI: 1.30–8.33, and p = 0.01), poorly differentiated tumors (HR: 2.52, 95% CI: 1.28–4.98, and p = 0.01), and lymphovascular invasion (LVI) (HR: 2.78, 95% CI: 1.27–6.09, and p = 0.01) were also significant independent covariates. The recurrence rates among patients with 0/1, 2, 3, and 4/5 poor prognostic factors were significantly different (5.0%, 25.0%, 35.7%, and 53.8%, respectively; p = 0.001); the survival rates were stratified among these prognostic groups.ConclusionsPretherapeutic CEA and NLR levels, pretherapeutic LNM, NACRT, poorly differentiated tumors, and LVI were significantly correlated with survivals in patients without pathological LNM after neoadjuvant therapy and surgery. Postoperative therapy should be considered in patients with ESCC with several indicators of recurrence, even in those without pathological LNM who underwent surgery following neoadjuvant therapy.

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Comparison of Open and Thoracoscopic Esophagectomy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma After Neoadjuvant Therapy

Cited by 4 publications

References 35 publications

A Study on Risk Factors Associated with Reflux Esophagitis in Patients Undergoing Esophageal Cancer Surgery

A Study on Risk Factors Associated with Reflux Esophagitis in Patients Undergoing Esophageal Cancer Surgery

Minimally invasive versus open esophagectomy after neoadjuvant therapy for esophageal cancer: a meta-analysis

Prognostic factors for esophageal squamous cell carcinoma without pathological lymph node metastasis after neoadjuvant therapy and surgery

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