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World Journal of Surgery

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01-07-2018 | Original Scientific Report

Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer

Authors: Styliani Mantziari, Pierre Allemann, Michael Winiker, Nicolas Demartines, Markus Schäfer

Published in: World Journal of Surgery | Issue 7/2018

Abstract

Background

Tumor recurrence during the first year after oncological esophagectomy has been reported in up to 17–66% of patients. However, little is known as to the risk factors potentially associated with this adverse outcome. The aim of this retrospective observational study was to identify clinically relevant parameters associated with early recurrence.

Methods

All patients with squamous cell cancer or adenocarcinoma of the esophagus or gastroesophageal junction, operated with curative intent in our center from 2000 to 2014, were screened for this study. Univariate analysis was conducted to identify variables potentially associated with early recurrence, and clinically relevant parameters with P < 0.1 were included in multiple logistic regression. Survival analyses were conducted with the Kaplan–Meier method. Significance threshold was set at P < 0.05.

Results

Among the 164 included patients, 46 (28%) presented early recurrence. Eight patients (17.4%) had locoregional and 38 patients (82.6%) metastatic recurrence. Advanced T and N stages, lymph node capsular effraction, a high positive-to-resected lymph node ratio, positive resection margins, poor response to neoadjuvant treatment, preoperative active smoking, malnutrition and dysphagia were associated with early recurrence on a univariate level. In multivariable analysis, preoperative smoking (OR 2.76, 95% CI 1.28–6.17), pT stage (OR 1.72, 95% CI 1.18–2.58) and an increased positive-to-resected lymph node ratio (OR 6.72, 95% CI 1.08–48.51) remained independently associated with ER.

Conclusion

Our study identified both patient- and tumor-related parameters as risk factors for early recurrence after oncological esophagectomy. Of particular interest, active smoking was significantly associated with this adverse outcome, highlighting the importance of preoperative smoking cessation.

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Title: Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer
Authors: Styliani Mantziari
Pierre Allemann
Michael Winiker
Nicolas Demartines
Markus Schäfer
Publication date: 01-07-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 7/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4422-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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