Surgical specialty, surgical unit volume and mortality after oesophageal cancer surgery

Leigh, Yasmin; Goldacre, M J; McCulloch, Peter

doi:10.1016/j.ejso.2008.11.004

Cited by 22 publications

(12 citation statements)

References 24 publications

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“…Bias may have been introduced by the small sample size of SSO training hospitals, a result of nonreporting of many of such programs to the NIS. That said, surgeons identifying themselves as thoracic surgeons have been shown to have improved outcomes over those identifying as general surgeons, 50 especially in low-volume centers.…”

Section: Mortality Ratesmentioning

confidence: 96%

National Trends in Esophageal Surgery—Are Outcomes as Good as We Believe?

Kohn

Galanko

Meyers

et al. 2009

Journal of Gastrointestinal Surgery

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Section: Mortality Ratesmentioning

confidence: 96%

National Trends in Esophageal Surgery—Are Outcomes as Good as We Believe?

Kohn

Galanko

Meyers

et al. 2009

Journal of Gastrointestinal Surgery

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“…12,13 To achieve this aim, accurate prognostication, development of better surgical care and chemoradiotherapeutic regimes, and identification of novel therapeutics are key areas to address. 5,6,12,[14][15][16] Previous studies have attempted to better determine prognosis for patients with EAC using nomograms based on clinical features. [17][18][19] There have also been a large number of studies correlating molecular markers, identified by either a candidate gene or gene expression microarray approach, to prognosis in this disease.…”

Section: Discussionmentioning

confidence: 99%

Three-Gene Immunohistochemical Panel Adds to Clinical Staging Algorithms to Predict Prognosis for Patients With Esophageal Adenocarcinoma

Ong

Shapiro

Nason

et al. 2013

JCO

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Purpose Esophageal adenocarcinoma (EAC) is a highly aggressive disease with poor long-term survival. Despite growing knowledge of its biology, no molecular biomarkers are currently used in routine clinical practice to determine prognosis or aid clinical decision making. Hence, this study set out to identify and validate a small, clinically applicable immunohistochemistry (IHC) panel for prognostication in patients with EAC. Patients and Methods We recently identified eight molecular prognostic biomarkers using two different genomic platforms. IHC scores of these biomarkers from a UK multicenter cohort (N = 374) were used in univariate Cox regression analysis to determine the smallest biomarker panel with the greatest prognostic power with potential therapeutic relevance. This new panel was validated in two independent cohorts of patients with EAC who had undergone curative esophagectomy from the United States and Europe (N = 666). Results Three of the eight previously identified prognostic molecular biomarkers (epidermal growth factor receptor [EGFR], tripartite motif-containing 44 [TRIM44], and sirtuin 2 [SIRT2]) had the strongest correlation with long-term survival in patients with EAC. Applying these three biomarkers as an IHC panel to the validation cohort segregated patients into two different prognostic groups (P < .01). Adjusting for known survival covariates, including clinical staging criteria, the IHC panel remained an independent predictor, with incremental adverse overall survival (OS) for each positive biomarker (hazard ratio, 1.20; 95% CI, 1.03 to 1.40 per biomarker; P = .02). Conclusion We identified and validated a clinically applicable IHC biomarker panel, consisting of EGFR, TRIM44, and SIRT2, that is independently associated with OS and provides additional prognostic information to current survival predictors such as stage.

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“…1 Esophageal resection is the mainstay therapy for malignancy of the esophagus; 2 this is a major surgical procedure still associated with significant morbidity and mortality. 3 During the past 15 years, several clinical trials involving the administration of a high-dose i.v. methylprednisolone have been undertaken in order to decrease the considerable inflammatory response to surgery, in an effort to decrease the supposedly associated morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%