Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma

Swanson, Scott J.; Batırel, Hasan Fevzi; Bueno, Raphael; Jaklitsch, Michael T.; Lukanich, Jeanne M.; Allred, Elizabeth N.; Mentzer, Steven J.; Sugarbaker, David J.

doi:10.1016/s0003-4975(01)03203-9

Cited by 188 publications

(100 citation statements)

References 22 publications

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“…EAC incidence has increased 6 folds in United States and Western countries in the last three decades and the prognosis is usually very poor with 5-year survival rates ranging from 14-22% [60][61][62][63]. While surgical treatment of EAC can offer cure, many patients first present as a disseminated disease and require systemic therapy.…”

Section: Her2 In Esophageal Adenocarcinomamentioning

confidence: 99%

HER2 Amplification or Overexpression in Upper GI Tract and Breast Cancer with Clinical Diagnosis and Treatment

Zhou¹,

Hick²

2013

Oncogene and Cancer - From Bench to Clinic

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Section: Her2 In Esophageal Adenocarcinomamentioning

confidence: 99%

HER2 Amplification or Overexpression in Upper GI Tract and Breast Cancer with Clinical Diagnosis and Treatment

Zhou¹,

Hick²

2013

Oncogene and Cancer - From Bench to Clinic

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“…It has been demonstrated that the presence of a solitary metastatic node -though an indicator of a poorer prognostic outcome compared with pN0 disease, is associated with significantly improved survival compared to greater nodal involvement [91,92] [91]. Furthermore, one particular study showed the 5-year survival rates for patients with no nodal involvement, one metastatic lymph node and two or more lymph nodes to be 57%, 33% and 10%, respectively [88].…”

Section: Solitary Lymph Node Involvementmentioning

confidence: 99%

“…Furthermore, one particular study showed the 5-year survival rates for patients with no nodal involvement, one metastatic lymph node and two or more lymph nodes to be 57%, 33% and 10%, respectively [88]. Thirty five percent of patients with solitary lymph node involvement may be cured after adequate lymphadenectomy [92]. In addition to this, patients with a solitary metastatic lymph node who receive pre-operative chemoradiation have been shown to have similar 5-year survival and recurrence free survival to patients without nodal involvement [91].…”

Section: Solitary Lymph Node Involvementmentioning

confidence: 99%

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Oesophageal cancer is the seventh most common cause of cancer-related death in the developed world and the incidence of oesophageal adenocarcinoma is now the fastest growing of any gastrointestinal cancer. Lymph node involvement is the single most important prognostic factor in oesophageal cancer. Imaging to determine the extent of lymph node involvement and plan treatment often requires a combination of modalities to avoid under-staging. The seventh edition of the staging system released by the International Union Against Cancer (IUCC) has stratified lymph node involvement according to the number of lymph nodes involved and redefined its groupings for location of metastatic lymph node involvement. This review discusses the prognostic and treatment implications of these modifications and explores micrometastatic lymph node involvement, capsular infiltration and lymph node ratio as possible additions to the staging system.

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“…About 9% of patients developed a chylothorax, 8% had an esophageal leak, and 5% developed a pneumonia. The length of stay was 13 days, and there was observed a 26% rate of strictures requiring some dilation postop (2).…”

Section: Clinical Resultsmentioning

confidence: 99%

Minimally invasive esophagectomy: the Brigham and Women’s Hospital experience

Wee

Bueno

Swanson

2017

Ann. Cardiothorac. Surg.

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A 68-year-old male presented with a long history of recurrent dysphagia secondary to Schatzki's ring for which he had previously required endoscopy and dilations in the past. He again developed symptoms of dysphagia that had progressed over several months resulting in a 15 pound weight loss and chronic fatigue. He had a barium swallow study that demonstrated a large mass causing partial obstruction in the distal esophagus as well as small hiatal hernia. Endoscopy demonstrated a large mass in the distal esophagus occupying nearly the entire lumen and was friable and with necrosis. The stomach and duodenum appeared normal. Biopsies of the esophageal mass demonstrated poorly differentiated adenocarcinoma, HER-2/neu positive. A computed tomography (CT) scan of the chest, abdomen and pelvis demonstrated a distal esophageal mass measuring 6.5 cm in length by 4.2 cm × 4.4 cm. The proximal esophagus above the mass was distended, but there was no evidence of any mediastinal, hilar or axillary lymphadenopathy. He had an endoscopic ultrasound that demonstrated a hypoechoic lesion that went through the muscularis propria measuring 3.1 cm × 3.8 cm. It was obstructing the lumen of the esophagus and the scope could not be advanced distally. He was staged at least a T3 Nx lesion. A positron emission tomography (PET) CT on 06/23/2016 demonstrated markedly hypermetabolic mass in the distal esophagus with SUVmax of 13.5. He underwent chemoradiotherapy neoadjuvant setting with cisplatin and etoposide and 5,040 cGy of XRT. Repeat PET/CT demonstrated some persistent avidity in the lower esophagus, but no additional activity. We proceeded onto surgical resection. Surgical technique PreparationPatients are given a clear liquid diet 24 hours preoperatively. We do not give a formal bowel prep as this leads to dehydration post-operatively. ExpositionOur approach is a minimally invasive Ivor Lewis e s o p h a g e c t o m y s t a r t i n g i n t h e s u p i n e p o s i t i o n laparoscopically, and then transitioning to a left laterally decubitus position for the chest direction. A foot board is utilized to allow for a step reverse trendelenburg position for laparoscopy.

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Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma

Cited by 188 publications

References 22 publications

HER2 Amplification or Overexpression in Upper GI Tract and Breast Cancer with Clinical Diagnosis and Treatment

HER2 Amplification or Overexpression in Upper GI Tract and Breast Cancer with Clinical Diagnosis and Treatment

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Minimally invasive esophagectomy: the Brigham and Women’s Hospital experience

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