Prognostic factors and patterns of recurrence in esophageal cancer assert arguments for extended two-field transthoracic esophagectomy

Smit, Jw; Pultrum, Bareld B.; Dullemen, Hendrik M. van; Dam, Gooitzen M. van; Groen, Henk; Plukker, John

doi:10.1016/j.amjsurg.2009.12.006

Cited by 46 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence demonstrated that there is a negative association between overall survival and lymph node ratio in N1 patients, and where different cut-off values were investigated, a ratio greater than 20% was frequently associated with poor overall survival in numerous studies. Similar results for lymph node ratio were also noted in other malignancies, such as gastric, oesophageal and colorectal cancers, [33][34][35] where it is a well-established independent prognostic factor for overall survival. 33 A systematic review by Ceelen et al on lymph node ratio in stage III colorectal cancer confirmed a hazard ratio for overall survival of 2.36 (95% confidence interval 2.14-2.61).…”

Section: Discussionsupporting

confidence: 66%

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Elshaer

Gravante

Kosmin

et al. 2017

annals

View full text Add to dashboard Cite

BACKGROUND Pancreatic ductal adenocarcinoma is the most common pancreatic cancer. Five-year overall survival is currently 3.3-6.0%. The aim of this review was to evaluate the prognostic value of lymph node ratio, number of positive nodes and total nodes examined on overall survival rate following pancreatic resection. MATERIALS AND METHODS A literature search was conducted of MEDLINE, EMBASE, the Cochrane Library and Central Register of Controlled Trials and the Cochrane Database of Systematic Review databases, from January 1996 to January 2016. RESULTS Overall, 19 studies including 4,883 patients examined the relationship between lymph node ratio and overall survival. A high lymph node ratio was associated with decreased overall survival in 17 studies. A total of 12 studies examined the relationship between the number of positive nodes and overall survival, and 11 studies revealed that an increase in the number of positive nodes was associated with decreased overall survival. In 15 studies examining the relationship between the total nodes examined and overall survival, there was no association with overall survival in 12 studies. CONCLUSIONS Lymph node ratio and number of positive nodes are factors associated with overall survival in pancreatic ductal adenocarcinoma, but not total nodes examined.

show abstract

Section: Discussionsupporting

confidence: 66%

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Elshaer

Gravante

Kosmin

et al. 2017

annals

View full text Add to dashboard Cite

show abstract

“…In turn, we have verified that our results concur with those from more extensive series published at international level (8,9,13,14).…”

Section: Discussionsupporting

confidence: 82%

“…The majority of the studies analysed (5,6,(8)(9)(10)(11)(12)(13)(14)16) have found that the degree of tumour invasion, as well as the presence of metastatic lymph, are variables that are asso- ciated with the recurrence of the disease, and similarly, in our study the patients with higher stages had a higher probability of recurrence.…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Characteristics and pattern of recurrence after curative surgery in oesophageal cancer

et al. 2015

View full text Add to dashboard Cite

Background and aim: Recurrence in oesophageal cancer continues to remain high after curative surgery. The aim of this study was to determine the presence of recurrence after curative surgery during follow-up, and the associated variables.Methods: A retrospective and prospective follow-up study in patients with an anatomical-pathological diagnosis of oesophageal cancer who underwent curative surgery (n = 57) in the health district of A Coruña (Spain) during the period [2003][2004][2005][2006][2007][2008]. The calculation of recurrence-free survival was made using a competing risks survival analysis.Results: Out of the 57 patients included in the study, 87.7% were men with a mean age of 61.4 ± 10.3 years. The median follow-up period was 18.5 months, during which 28 recurrences were detected (50.9%). Patients with dysphagia on diagnosis of the disease, as well as patients in stages III-IV, have a higher probability of recurrence during the follow-up period. The median disease-free interval was 8.5 months. After one year of follow up, 57.1% of the recurrences were diagnosed and 82.1% after 2 years of followup. The median post-recurrence survival rate was 4.7 months. After adjusting for a multivariate regression model, the variable with an independent effect for predicting recurrence is the TNM classification (HR = 8.49).Conclusions: The majority of the recurrences will be developed during the 2 years after surgery, with a very poor prognosis. The predictor variable for recurrence is the TMN classification.

show abstract

“…Isolated recurrence was defined as a situation with no evidence of metachronous recurrence within 6 weeks. If a second recurrence was confirmed within 6 weeks of the first, it was deemed synchronous10.…”

Section: Methodsmentioning

confidence: 99%

Patterns of recurrence in oesophageal cancer following oesophagectomy in the era of neoadjuvant chemotherapy

Knight

Zylstra²,

Hemelrijck

et al. 2017

BJS Open

View full text Add to dashboard Cite

BackgroundTumour recurrence following oesophagectomy for oesophageal cancer is common despite neoadjuvant treatment. Understanding patterns of recurrence and risk factors associated with locoregional and systemic recurrence might influence future treatment strategies.MethodsThis was a cohort study involving patients undergoing resection for adenocarcinoma or squamous cell carcinoma of the oesophagus between 2000 and 2014. Clinicopathological factors associated with locoregional and systemic recurrence were analysed using multivariable logistic regression to determine odds ratios (ORs) and 95 per cent confidence intervals.ResultsSome 698 patients were identified. Lymphovascular invasion (OR 2·09, 95 per cent c.i. 1·18 to 3·71) and preoperative stenting (OR 3·70, 1·34 to 10·23) were independent risk factors for isolated locoregional recurrence. Pathological nodal disease in patients with pT1–2 (pN1: OR 2·72, 1·35 to 5·48; pN2–3: OR 5·00, 2·35 to 10·66) or pT3–4 (pN1: OR 3·03, 1·51 to 6·07; pN2–3: OR 5·75, 3·15 to 10·49) disease predisposed to systemic recurrence. Poor or no response to chemotherapy was also an independent risk factor for isolated systemic recurrence (OR 1·85, 1·05 to 3·26). A positive resection margin (R1 resection) was not associated with a significantly increased risk of isolated locoregional recurrence (OR 1·37, 0·81 to 2·33).ConclusionThese findings confirm that oesophageal adenocarcinoma is frequently a systemic disease. Understanding the key predictors of local and systemic recurrence may facilitate the tailoring of oncological therapies to the individual patient.

show abstract

Prognostic factors and patterns of recurrence in esophageal cancer assert arguments for extended two-field transthoracic esophagectomy

Abstract: Radicality and LN ratio are strong prognostic factors. High radicality and adequate nodal assessment are guaranteed by an extended transthoracic approach.

Cited by 46 publications

References 26 publications

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

A systematic review of the prognostic value of lymph node ratio, number of positive nodes and total nodes examined in pancreatic ductal adenocarcinoma

Characteristics and pattern of recurrence after curative surgery in oesophageal cancer

Patterns of recurrence in oesophageal cancer following oesophagectomy in the era of neoadjuvant chemotherapy

Contact Info

Product

Resources

About