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Published in: World Journal of Surgical Oncology 1/2018

Open Access 01-12-2018 | Research

Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients

Authors: Weiran Zhang, Ban Liu, Yue Zhou, Feng Wang, Chang Gu, Qi Wang, Xiaofang Wang, Yangyang Zhang

Published in: World Journal of Surgical Oncology | Issue 1/2018

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Abstract

Objective

The co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients.

Methods

Prospective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first beating-heart coronary artery bypass grafting (off-pump CABG) and then esophagectomy, were involved as group A. Then, 44 patients undergoing isolated esophagectomy were selected as group B using the propensity score matching method. Data including clinic pathological characteristics and postoperative outcomes were investigated. Kaplan–Meier analysis was used.

Results

The surgical procedure was performed through left lateral thoracotomy in all patients, except one patient in group A who received median sternotomy and left lateral thoracotomy. The operation time and blood loss were both more in group A, as a result of two operations performed at one session. Patients in both groups were followed up from 1.3 to 78.3 months. No significant between-group was found in overall survival or relapse-free survival.

Conclusion

The risk of simultaneous esophagectomy and cardiac surgery is not high. Despite certain differences in clinical indicators between groups, the safety of simultaneous procedures in group A is evident.

Trial registration

ChiCTR 1800014498. Registered 17 January 2018
Appendix
Available only for authorised users
Literature
1.
go back to reference GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–544. https://doi.org/10.1016/S0140-6736(16)31012-1.CrossRef GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–544. https://​doi.​org/​10.​1016/​S0140-6736(16)31012-1.CrossRef
2.
go back to reference Zhang XH, Lu ZL, Liu L. Coronary heart disease in China. Heart. 2008;94:1126–31.CrossRef Zhang XH, Lu ZL, Liu L. Coronary heart disease in China. Heart. 2008;94:1126–31.CrossRef
3.
go back to reference Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86.CrossRef Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86.CrossRef
4.
go back to reference Chen WQ, Zheng RS, Zhang SW, Li N, Zhao P, Li GL, Wu LY, He J. Report of incidence and mortality in China cancer registries, 2008. Chin J Cancer Res. 2012;24:171–80.CrossRef Chen WQ, Zheng RS, Zhang SW, Li N, Zhao P, Li GL, Wu LY, He J. Report of incidence and mortality in China cancer registries, 2008. Chin J Cancer Res. 2012;24:171–80.CrossRef
5.
go back to reference Chassot PG, Delabays A, Spahn DR. Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. Br J Anaesth. 2002;89:747–59.CrossRef Chassot PG, Delabays A, Spahn DR. Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. Br J Anaesth. 2002;89:747–59.CrossRef
7.
go back to reference Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest. 2000;118:1263–70.CrossRef Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest. 2000;118:1263–70.CrossRef
8.
go back to reference Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2215–45.CrossRef Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2215–45.CrossRef
9.
go back to reference King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O'Neill WW, Schaff HV, Whitlow PL, Acc/Aha/Scai, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol. 2008;51:172–209.CrossRef King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O'Neill WW, Schaff HV, Whitlow PL, Acc/Aha/Scai, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol. 2008;51:172–209.CrossRef
10.
go back to reference Kaluza GL, Joseph J, Lee JR, Raizner ME, Raizner AE. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol. 2000;35:1288–94.CrossRef Kaluza GL, Joseph J, Lee JR, Raizner ME, Raizner AE. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol. 2000;35:1288–94.CrossRef
11.
go back to reference Suzuki S, Usui A, Yoshida K, Matsuura A, Ichihara T, Ueda Y. Effect of cardiopulmonary bypass on cancer prognosis. Asian Cardiovasc Thorac Ann. 2010;18:536–40.CrossRef Suzuki S, Usui A, Yoshida K, Matsuura A, Ichihara T, Ueda Y. Effect of cardiopulmonary bypass on cancer prognosis. Asian Cardiovasc Thorac Ann. 2010;18:536–40.CrossRef
13.
go back to reference Chan J, Rosenfeldt F, Chaudhuri K, Marasco S. Cardiac surgery in patients with a history of malignancy: increased complication rate but similar mortality. Heart Lung Circ. 2012;21:255–9.CrossRef Chan J, Rosenfeldt F, Chaudhuri K, Marasco S. Cardiac surgery in patients with a history of malignancy: increased complication rate but similar mortality. Heart Lung Circ. 2012;21:255–9.CrossRef
14.
go back to reference Canver CC, Bhayana JN, Lajos TZ, Raza ST, Lewin AN, Bergsland J, Mentzer RM Jr. Pulmonary resection combined with cardiac operations. Ann Thorac Surg. 1990;50:796–9.CrossRef Canver CC, Bhayana JN, Lajos TZ, Raza ST, Lewin AN, Bergsland J, Mentzer RM Jr. Pulmonary resection combined with cardiac operations. Ann Thorac Surg. 1990;50:796–9.CrossRef
15.
go back to reference Elami A, Korach A, Rudis E. Lung cancer resection or aortic graft replacement with simultaneous myocardial revascularization without cardiopulmonary bypass. Chest. 2001;119:1941–3.CrossRef Elami A, Korach A, Rudis E. Lung cancer resection or aortic graft replacement with simultaneous myocardial revascularization without cardiopulmonary bypass. Chest. 2001;119:1941–3.CrossRef
16.
go back to reference Yang Y, Xiao F, Wang J, Song B, Li XH, Li J, He ZS, Zhang H, Yin L. Simultaneous surgery in patients with both cardiac and noncardiac diseases. Patient Prefer Adherence. 2016;10:1251–8.CrossRef Yang Y, Xiao F, Wang J, Song B, Li XH, Li J, He ZS, Zhang H, Yin L. Simultaneous surgery in patients with both cardiac and noncardiac diseases. Patient Prefer Adherence. 2016;10:1251–8.CrossRef
17.
go back to reference Chaudhry UA, Harling L, Rao C, Ashrafian H, Ibrahim M, Kokotsakis J, Casula R, Athanasiou T. Off-pump versus on-pump coronary revascularization: meta-analysis of mid- and long-term outcomes. Ann Thorac Surg. 2014;98:563–72.CrossRef Chaudhry UA, Harling L, Rao C, Ashrafian H, Ibrahim M, Kokotsakis J, Casula R, Athanasiou T. Off-pump versus on-pump coronary revascularization: meta-analysis of mid- and long-term outcomes. Ann Thorac Surg. 2014;98:563–72.CrossRef
18.
go back to reference Nozoe T, Kakeji Y, Baba H, Maehara Y. Two-field lymph-node dissection may be enough to treat patients with submucosal squamous cell carcinoma of the thoracic esophagus. Dis Esophagus. 2005;18:226–9.CrossRef Nozoe T, Kakeji Y, Baba H, Maehara Y. Two-field lymph-node dissection may be enough to treat patients with submucosal squamous cell carcinoma of the thoracic esophagus. Dis Esophagus. 2005;18:226–9.CrossRef
19.
go back to reference Ma J, Zhan C, Wang L, Jiang W, Zhang Y, Shi Y, Wang Q. The sweet approach is still worthwhile in modern esophagectomy. Ann Thorac Surg. 2014;97:1728–33.CrossRef Ma J, Zhan C, Wang L, Jiang W, Zhang Y, Shi Y, Wang Q. The sweet approach is still worthwhile in modern esophagectomy. Ann Thorac Surg. 2014;97:1728–33.CrossRef
20.
go back to reference Mariette C, Taillier G, Van Seuningen I, Triboulet JP. Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg. 2004;78:1177–83.CrossRef Mariette C, Taillier G, Van Seuningen I, Triboulet JP. Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg. 2004;78:1177–83.CrossRef
21.
go back to reference Chang AC, Ji H, Birkmeyer NJ, Orringer MB, Birkmeyer JD. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg. 2008;85:424–9.CrossRef Chang AC, Ji H, Birkmeyer NJ, Orringer MB, Birkmeyer JD. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg. 2008;85:424–9.CrossRef
22.
go back to reference Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–37.CrossRef Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–37.CrossRef
23.
go back to reference Dimick JB, Goodney PP, Orringer MB, Birkmeyer JD. Specialty training and mortality after esophageal cancer resection. Ann Thorac Surg. 2005;80:282–6.CrossRef Dimick JB, Goodney PP, Orringer MB, Birkmeyer JD. Specialty training and mortality after esophageal cancer resection. Ann Thorac Surg. 2005;80:282–6.CrossRef
Metadata
Title
Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients
Authors
Weiran Zhang
Ban Liu
Yue Zhou
Feng Wang
Chang Gu
Qi Wang
Xiaofang Wang
Yangyang Zhang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1512-5

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