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01-06-2011

How Radical Should Surgery Be for Early Esophageal Cancer?

Authors: Dean Bogoevski, Maximilian Bockhorn, Alexandra Koenig, Matthias Reeh, Katharina von Loga, Guido Sauter, Thomas Rösch, Jakob R. Izbicki

Published in: World Journal of Surgery | Issue 6/2011

Abstract

Background

We have compared the oncologic effectiveness of limited resection (LR) techniques such as transhiatal (TH) or limited resection of the esophagogastric junction with intestinal interposition (LREGJ) in the treatment of early esophageal carcinoma with that of the extended resection such as the classical thoracoabdominal (TA) en bloc esophagectomy.

Methods

We performed a retrospective analysis of prospectively collected data of 113 patients with T1 esophageal cancer (57 adeno- and 56 squamous cell carcinomas) who had surgical resection with systematic lymphadenectomy. Forty-one underwent extensive (TA) and 72 limited resection (51 TH and 21 LREGJ).

Results

Complete resection (R0) was achieved in all cases. Lymphatic metastases were seen in none of the mucosal but in 26.8% of the submucosal T1 cancers. The median lymph node yield was significantly higher in patients with extensive resection (24 vs. 15 lymph nodes; p = 0.036), but this did not affect the overall survival (median = 88 vs. 102 months, 5-year survival probability = 57.8 vs. 67.7%; log rank = 0.578). The median hospital stay and ICU stay were significantly shorter in the LR group (p = 0.039 and p = 0.044, respectively).

Conclusion

Limited resection leads to lower lymph node yield but similar oncologic effectiveness as the extensive surgery. It may represent a valuable alternative in the treatment of patients with early (submucosal) esophageal carcinoma.

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Title: How Radical Should Surgery Be for Early Esophageal Cancer?
Authors: Dean Bogoevski
Maximilian Bockhorn
Alexandra Koenig
Matthias Reeh
Katharina von Loga
Guido Sauter
Thomas Rösch
Jakob R. Izbicki
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1069-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How Radical Should Surgery Be for Early Esophageal Cancer?

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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