A French multicenter database was used to assess the relationship between severe anastomotic leak on outcomes after esophagectomy. Among 2439 pts, 8.5% developed a severe leak. This was associated with lower median overall survival (36 mos vs 55 mos) and disease-free survival (34 mos vs 48 mos), a 28% increased likelihood of death, and a significan
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Esophageal Cancer - Surgery
The Impact of Severe Anastomotic Leak on Long-term Survival and Cancer Recurrence After Surgical Resection for Esophageal Malignancy
November 11, 2015
Does Quality of Care Matter? A Study of Adherence to National Comprehensive Cancer Network Guidelines for Patients with Locally Advanced Esophageal Cancer
October 12, 2015
This single institution study evaluated compliance with NCCN guidelines in the management of stage II-III esophageal cancer. Overall compliance was 81%, and was related to younger age, white race, and higher education level. Compliance was associated with improved survival.
October 8, 2015
The authors evaluated a single year of thoracic surgery operations at their institution and compared outcomes based on data in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), which uses a sampling technique, to the STS General Thoracic Database, a comprehensive data collection system. Globally, NSQIP under
The revised American Joint Committee on Cancer staging system (7th edition) improves prognostic stratification after minimally invasive esophagectomy for esophagogastric adenocarcinoma
September 16, 2015
The 6th and 7th versions of the AJCC staging system were compared for their prognostic accuracy for patients with esophagogastric adenocarcinomas using an institutional database. The 7th edition system was significantly more accurate in groups undergoing MIE, induction therapy, and overall.
September 8, 2015
This single institution study involving 606 patients operated 2000-2012 examined the influence of the extent of lymphadenectomy on survival. The number of nodes resected was not related to all-cause mortality, even comparing the highest and lowest quartiles. The number of metastatic nodes and an increasing ratio of positive to negative nodes were e
Salvage Surgery After Chemoradiotherapy in the Management of Esophageal Cancer: Is It a Viable Therapeutic Option?
July 23, 2015
This multicenter retrospective study evaluated the efficacy of salvage esophagectomy after definitive chemoradiotherapy compared to planned esophagectomy after induction chemoradiotherapy. Operative mortality was similarly high in both groups (8.4% vs 9.3%). Anastomotic leak was higher after salvage esophagectomy (17.2% vs 10.7%). 3-year survival
International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy: Esophagectomy Complications Consensus Group (ECCG)
July 14, 2015
This important consensus statement on definitions of postoperative complications after esophagectomy was developed by an international group of surgical experts. It should serve as a template for data collection and reporting for clinical reports and trials.
Randomized Phase II Study of the Anti-inflammatory Effect of Ghrelin During the Postoperative Period of Esophagectomy
July 14, 2015
This small randomized trial evaluated the potential benefits of ghrelin, an anti-inflammatory agent, in reducing the SIRS response after esophagectomy. The ghrelin group had a reduced SIRS duration, lower CRP levels, and lower IL-6 levels compared to controls. Pulmonary complications were reduced in the ghrelin group, but other complication inciden
Is It Time to Centralize High-risk Cancer Care in the United States? Comparison of Outcomes of Esophagectomy Between England and the United States
June 12, 2015
Outcomes of esophagectomy, including in-hospital mortality and length of stay (LOS), were compared between England (centralized care) and the US (no centralized care). Data for 2005-2010 included 7433 esophagectomies performed in 66 hospitals in England and 5858 esophagectomies performed in 775 hospitals in the US. Morality was greater in the US (5
Intraoperative Assessment of Perfusion of the Gastric Graft and Correlation With Anastomotic Leaks After Esophagectomy
June 12, 2015
Laser-assisted fluorescent-dye angiography (LAA) was used prospectively in 150 patients undergoing esophagectomy with gastric pull-up to assess blood flow in the gastric tube. Anastomotic leak occured in 17%. Anastomoses performed in areas of normal perfusion had a 2% leak rate, compared to a 45% leak rate when anastomoses were performed in areas o