Postoperative complications and survival after surgical resection of esophageal squamous cell carcinoma

Rasmussen, Steen; Nielsen, Rikke Vibeke; Fenger, Anne‐Sophie; Siemsen, Mette; Ravn, Hanne Berg

doi:10.21037/jtd.2018.07.04

Cited by 20 publications

(15 citation statements)

References 31 publications

(57 reference statements)

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“…A total of 133 patients were enrolled in this study cohort, with a mean age of 65 years. AL was proven by water-soluble contrast swallow, CT scan (31). Patients without complications had long-term survival of 52%.…”

Section: Discussionmentioning

confidence: 99%

Recurrence Following Anastomotic Leakage After Surgery for Carcinoma of the Distal Esophagus and Gastroesophageal Junction: A Systematic Review

et al. 2019

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Background: Esophageal cancer is the ninth most common cancer. The only potentially curative treatment is surgical resection, which unfortunately is still associated with major complications, the most important being anastomotic leakage, currently with an overall rate of up to 26% morbidity. The aim of this systematic review was to evaluate the relationship between anastomotic leakage and recurrence of disease. Materials and Methods: A literature search was systematically performed. Seven out of 312 articles dated between 2009 and 2018 fulfilled the selection for a total of 5,433 patients. Results: The frequency of anastomotic leakage ranged from 7.2 to 11.2%. Patients affected by anastomotic leakage had a recurrence rate of 9-56%. Conclusion: Closer follow-up or even more aggressive oncological therapy should be considered for patients affected by anastomotic leakage after surgery for carcinoma of the distal esophagus and gastroesophageal junction.

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Section: Discussionmentioning

confidence: 99%

Recurrence Following Anastomotic Leakage After Surgery for Carcinoma of the Distal Esophagus and Gastroesophageal Junction: A Systematic Review

et al. 2019

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“…In addition, mean total costs in the surgery phase for ESC patients were generally higher than EAC patients, ranging from $59 494‐$84 538 for ESC stages I‐III vs $54 854‐$70 280 for EAC stages I‐III. These differences are possibly due to the higher rates of postoperative complication rates found in ESC patients, including pulmonary complications requiring longer hospital stays . These complications could potentially last over several months.…”

Section: Discussionmentioning

confidence: 99%

“…These differences are possibly due to the higher rates of postoperative complication rates found in ESC patients, including pulmonary complications requiring longer hospital stays. [30][31][32] These complications could potentially last over several months.…”

Section: Discussionmentioning

confidence: 99%

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

et al. 2019

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Background Detailed cost estimates are not widely available for esophageal cancer. Our study estimates phase‐specific costs for esophageal cancer by age, year, histology, stage, and treatment for older patients in the United States and compares these costs within stage and treatment modalities. Methods We identified 8061 esophageal cancer patients in the Surveillance, Epidemiology, and End Results‐Medicare database for years 1998‐2013. Total, cancer‐attributable, and patient‐liability costs were calculated based on separate phases of care—staging (or surgery), initial, continuing, and terminal. We estimated costs by treatment modality within stage and phase for esophageal adenocarcinoma and squamous cell carcinoma separately. We fit linear regression models using log transformation to determine cost by age and calendar year. All costs are reported in 2018 US dollars. Results Overall, mean (95% CI) monthly total cost estimates were high during the staging ($8953 [$8385‐$9485]) and initial phases ($7731 [$7492‐$7970]), decreased over the continuing phase ($2984 [$2814‐$3154]), and increased substantially during the 6‐month terminal phase ($18 150 [$17 211‐$19 089]). This pattern of high staging and initial phase costs, decreasing continuing phase costs, and increasing terminal phase costs was seen in all stages. The highest staging costs were in stages III ($9249, $8025‐$10 474) and II ($9171, $7642‐$10 699). The highest initial phase cost was in stage IV, $9263 ($8758‐49 768), the lowest continuing phase cost was in stage I, $2338 ($2160‐$2517), and the highest terminal phase costs were in stages II ($20 533, $17 772‐$23 293) and III ($20 599, $18 268‐$22 929). The linear regression models showed that cancer‐attributable costs remained stable over the study period and were unaffected by age for most histology, stage, and treatment modality subgroups. Conclusions Our estimates demonstrate that esophageal cancer costs can vary widely by histology, stage, and treatment. These cost estimates can be used to guide future resource allocation for esophageal cancer care and research.

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“…Therefore, we were unable to evaluate any relationship between oncologic outcomes such as recurrence-free survival or have any insight into speci c therapy regimens. Similarly, we were also unable to track speci c intraoperative and postoperative complications with regards to surgery as well as the multi-modal therapies (22). Additionally, Samson et al showed worse survival for upfront esophagectomy patients whom were upstaged with only 44.2% receiving adjuvant therapy and median overall survival of 27.5 months vs 43.9 months in neoadjuvant cT2 N0 patients.…”

Section: Discussionmentioning

confidence: 85%

The Ideal Approach for Treatment of cT1N+ and cT2Nany Esophageal Cancer.: A NCDB Analysis

Huang

Chan

Pennathur

et al. 2021

Preprint

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Background Neoadjuvant therapy followed by surgery is recommended for locally advanced esophageal cancer. With the inaccuracies of clinical staging particularly for cT1N+ and cT2Nany tumors, some have proposed consideration of surgery followed by adjuvant treatment. Our objective is to evaluate the efficacy of neoadjuvant therapy vs surgery followed by adjuvant therapy, and to identify the ideal sequence of treatment in patients with cT1N+ and cT2Nany tumors.Methods We performed an analysis utilizing the National Cancer Database (2006-2015) identifying all patients with cT1N+ and cT2Nany esophageal cancer undergoing esophagectomy and additional chemotherapy or radiotherapy. The treatment was stratified as: neoadjuvant therapy (NT), adjuvant therapy (AT) and combination therapy of neoadjuvant and adjuvant (CT) groups and outcomes were analyzed.Results We identified 2795 patients with 81.9% (n=2289) receiving NT, 10.2% (n=285) AT, and 7.9% (n=221) CT. There were no significant differences noted in survival among AT, NT, and CT group in cT1N+(P=0.376), cT2N-(P=0.436), cT2N+(P=0.261) esophageal cancer by multivariate analysis using Cox regression model. This relationship held true in both squamous cell carcinoma and adenocarcinoma. Conclusion In clinical T1N+, T2Nany patients, there was no evident superiority of NT over AT. Surgery followed by adjuvant therapy can be considered to be an alternative option in these patients. Further prospective studies are needed to validate these findings.

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Postoperative complications and survival after surgical resection of esophageal squamous cell carcinoma

Cited by 20 publications

References 31 publications

Recurrence Following Anastomotic Leakage After Surgery for Carcinoma of the Distal Esophagus and Gastroesophageal Junction: A Systematic Review

Recurrence Following Anastomotic Leakage After Surgery for Carcinoma of the Distal Esophagus and Gastroesophageal Junction: A Systematic Review

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

The Ideal Approach for Treatment of cT1N+ and cT2Nany Esophageal Cancer.: A NCDB Analysis

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