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
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Esophageal Cancer - Surgery
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
June 11, 2015
This single institution retrospective analysis of esophagectomy or gastrectomy for GEJ cancer compared outcomes between groups who did and did not complete recommended 2 cycles of postoperative adjuvant chemotherapy. Of 110 pts who underwent perioperative chemotherapy, 67% completed postoperative adjuvant chemotherapy. Completion of 2 cycles or mor
May 17, 2015
In this population-based cohort study with 1044 patients who underwent esophagectomy for esophageal cancer between 1987 and 2010 in Sweden, the researchers found that a higher number of lymph nodes removed did not affect mortality in any specific stage.
January 29, 2015
There is growing recognition that hospital mortality is not an accurate metric for surgery-related mortality after cancer operations. This article evaluated SEER data for 1-month mortality after cancer surgery in nearly 54,000 patients. 4.8% died within 1 month of surgery. Favorable factors included being married, being insured, having an above-me
January 10, 2015
The authors retrospectively analyzed pathologic response rates and their relation to the interval between completion of induction therapy and esophagectomy for esophageal cancer in 88 patients. Complete response rates increased from 12.5% to 40.9% among quartiles as the interval increased from <45 days to >63 days. There was no increase in mo
November 20, 2014
Data from 20 observational studies including nearly 3000 pts were reviewed to assess the prevalence of pre-frailty/frailty and clinical outcomes in older cancer patients. Frailty was identified in 42% and pre-frailty in 43% of patients. Combined frailty was associated with increased all cause mortality (5-yr HR 1.57), postoperative mortality, and p
November 16, 2014
This article systematically reviewed the impact of surgical adverse events (SAEs) on quality of life after major GI surgery. The mean difference in QOL between pts with and without SAEs was highest for esophagectomy (0.14; scale 0 to 1), while results for antireflux surgery were mixed.
November 5, 2014
Long-term QOL outcomes were assessed in a single institution cohort of 63 patients undergoing colon interposition after esophagectomy. 48% of pts had a vagal sparing operation, and resection was performed for cancer in the majority of the pts. Followup median was 13 yrs. Mean SF36 scores were above the published average and GI QOL was 3 out of 4.
October 8, 2014
This multicenter prospective trial evaluated the impact of induction therapy on anastomotic leak (AL) and other complications after esophagectomy. Of 2944 included pts, 593 had induction chemoradiotherapy. AL occurred in 8.8% of induction therapy pts compared to 10.6% of surgery only patients. 90 day postoperative morbidity and mortality rates wer