Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer

A. R. Davies; H. Sandhu; A. Pillai; P. Sinha; F. Mattsson; M. J. Forshaw; James Gossage; J. Lagergren; W. H. Allum; Robert Mason

doi:10.1002/bjs.9456

Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer

A. R. Davies^*, H. Sandhu, A. Pillai, P. Sinha, F. Mattsson, M. J. Forshaw, James Gossage, J. Lagergren, W. H. Allum, Robert Mason

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

57 Citations (Scopus)

Abstract

Background: The optimal surgical approach to tumours of the oesophagus and oesophagogastric junction remains controversial. The principal randomized trial comparing transhiatal (THO) and transthoracic (TTO) oesophagectomy showed no survival difference, but suggested that some subgroups of patients may benefit from the more extended lymphadenectomy typically conducted with TTO.

Methods: This was a cohort study based on two prospectively created databases. Short- and long-term outcomes for patients undergoing THO and TTO were compared. The primary outcome measure was overall survival, with secondary outcomes including time to recurrence and patterns of disease relapse. A Cox proportional hazards model provided hazard ratios (HRs) and 95 per cent confidence intervals (c.i.), with adjustments for age, tumour stage, tumour grade, response to chemotherapy and lymphovascular invasion.

Results: Of 664 included patients (263 THO, 401 TTO), the distributions of age, sex and histological subtype were similar between the groups. In-hospital mortality (1.1 versus 3.2 per cent for THO and TTO respectively; P=0.110) and in-hospital stay (14 versus 17 days respectively; P

Conclusion: There was no difference in survival or tumour recurrence for TTO and THO.

Surgical approach makes little difference to long-term outcomes

Original language	English
Article number	N/A
Pages (from-to)	511-517
Number of pages	7
Journal	British Journal of Surgery
Volume	101
Issue number	5
DOIs	https://doi.org/10.1002/bjs.9456
Publication status	Published - Apr 2014

Keywords

LIMITED TRANSHIATAL RESECTION
LYMPH-NODE DISSECTION
ESOPHAGOGASTRIC JUNCTION
NEOADJUVANT CHEMOTHERAPY
TRANSTHORACIC RESECTION
GASTROESOPHAGEAL CANCER
PREDICTS SURVIVAL
GASTRIC-CANCER
CARCINOMA
NUMBER

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer",

abstract = "Background: The optimal surgical approach to tumours of the oesophagus and oesophagogastric junction remains controversial. The principal randomized trial comparing transhiatal (THO) and transthoracic (TTO) oesophagectomy showed no survival difference, but suggested that some subgroups of patients may benefit from the more extended lymphadenectomy typically conducted with TTO.Methods: This was a cohort study based on two prospectively created databases. Short- and long-term outcomes for patients undergoing THO and TTO were compared. The primary outcome measure was overall survival, with secondary outcomes including time to recurrence and patterns of disease relapse. A Cox proportional hazards model provided hazard ratios (HRs) and 95 per cent confidence intervals (c.i.), with adjustments for age, tumour stage, tumour grade, response to chemotherapy and lymphovascular invasion.Results: Of 664 included patients (263 THO, 401 TTO), the distributions of age, sex and histological subtype were similar between the groups. In-hospital mortality (1.1 versus 3.2 per cent for THO and TTO respectively; P=0.110) and in-hospital stay (14 versus 17 days respectively; PConclusion: There was no difference in survival or tumour recurrence for TTO and THO.Surgical approach makes little difference to long-term outcomes",

keywords = "LIMITED TRANSHIATAL RESECTION, LYMPH-NODE DISSECTION, ESOPHAGOGASTRIC JUNCTION, NEOADJUVANT CHEMOTHERAPY, TRANSTHORACIC RESECTION, GASTROESOPHAGEAL CANCER, PREDICTS SURVIVAL, GASTRIC-CANCER, CARCINOMA, NUMBER",

author = "Davies, {A. R.} and H. Sandhu and A. Pillai and P. Sinha and F. Mattsson and Forshaw, {M. J.} and James Gossage and J. Lagergren and Allum, {W. H.} and Robert Mason",

year = "2014",

month = apr,

doi = "10.1002/bjs.9456",

language = "English",

volume = "101",

pages = "511--517",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "John Wiley & Sons, Ltd",

number = "5",

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TY - JOUR

T1 - Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer

AU - Davies, A. R.

AU - Sandhu, H.

AU - Pillai, A.

AU - Sinha, P.

AU - Mattsson, F.

AU - Forshaw, M. J.

AU - Gossage, James

AU - Lagergren, J.

AU - Allum, W. H.

AU - Mason, Robert

PY - 2014/4

Y1 - 2014/4

N2 - Background: The optimal surgical approach to tumours of the oesophagus and oesophagogastric junction remains controversial. The principal randomized trial comparing transhiatal (THO) and transthoracic (TTO) oesophagectomy showed no survival difference, but suggested that some subgroups of patients may benefit from the more extended lymphadenectomy typically conducted with TTO.Methods: This was a cohort study based on two prospectively created databases. Short- and long-term outcomes for patients undergoing THO and TTO were compared. The primary outcome measure was overall survival, with secondary outcomes including time to recurrence and patterns of disease relapse. A Cox proportional hazards model provided hazard ratios (HRs) and 95 per cent confidence intervals (c.i.), with adjustments for age, tumour stage, tumour grade, response to chemotherapy and lymphovascular invasion.Results: Of 664 included patients (263 THO, 401 TTO), the distributions of age, sex and histological subtype were similar between the groups. In-hospital mortality (1.1 versus 3.2 per cent for THO and TTO respectively; P=0.110) and in-hospital stay (14 versus 17 days respectively; PConclusion: There was no difference in survival or tumour recurrence for TTO and THO.Surgical approach makes little difference to long-term outcomes

AB - Background: The optimal surgical approach to tumours of the oesophagus and oesophagogastric junction remains controversial. The principal randomized trial comparing transhiatal (THO) and transthoracic (TTO) oesophagectomy showed no survival difference, but suggested that some subgroups of patients may benefit from the more extended lymphadenectomy typically conducted with TTO.Methods: This was a cohort study based on two prospectively created databases. Short- and long-term outcomes for patients undergoing THO and TTO were compared. The primary outcome measure was overall survival, with secondary outcomes including time to recurrence and patterns of disease relapse. A Cox proportional hazards model provided hazard ratios (HRs) and 95 per cent confidence intervals (c.i.), with adjustments for age, tumour stage, tumour grade, response to chemotherapy and lymphovascular invasion.Results: Of 664 included patients (263 THO, 401 TTO), the distributions of age, sex and histological subtype were similar between the groups. In-hospital mortality (1.1 versus 3.2 per cent for THO and TTO respectively; P=0.110) and in-hospital stay (14 versus 17 days respectively; PConclusion: There was no difference in survival or tumour recurrence for TTO and THO.Surgical approach makes little difference to long-term outcomes

KW - LIMITED TRANSHIATAL RESECTION

KW - LYMPH-NODE DISSECTION

KW - ESOPHAGOGASTRIC JUNCTION

KW - NEOADJUVANT CHEMOTHERAPY

KW - TRANSTHORACIC RESECTION

KW - GASTROESOPHAGEAL CANCER

KW - PREDICTS SURVIVAL

KW - GASTRIC-CANCER

KW - CARCINOMA

KW - NUMBER

U2 - 10.1002/bjs.9456

DO - 10.1002/bjs.9456

M3 - Article

SN - 0007-1323

VL - 101

SP - 511

EP - 517

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 5

M1 - N/A

ER -

Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer

Abstract

Keywords

UN SDGs

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