The authors investigated the impact of new onset a-fib after esophagectomy in 437 pts. Risk factors included age, diabetes, induction therapy, and cardiac history. A-fib was associated with postoperative pneumonia, symptomatic pleural effusions, and an increase in C-reactive protein. It was not associated with anastomotic leak or mortality. 92% o
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Esophageal Cancer - Surgery
October 8, 2014
It has recently been reported that the number of lymph nodes resected during esophagectomy is related to long-term survival, leading to recommendations for the proper extent of nodal dissection. The current study used data from the CROSS trial to investigate this relationship in groups of esophagectomy patients with and without induction chemoradiot
October 8, 2014
It has recently been reported that a longer interval to esophagectomy following induction therapy results in higher pathologic response rates. The current study used data from the CROSS trial to determine whether a longer interval to esophagectomy following induction therapy results in improved survival. Time to surgery (TTS) was a median of 48 day
October 8, 2014
The Comprehensive Complication Index (CCI) was compared to more standard methods of categorizing complications for their utility in assessing outcomes after randomized surgical trials. The CCI outperformed standard methods in 2 of 3 published randomized trials (pancreatic and esophageal surgery), demonstrating significant differences in outcomes whe
September 16, 2014
This retrospective study evaluated recurrence patterns and management of recurrence after bimodality (chemoradiotherapy) for esophageal cancer in 276 pts. Local relapse alone developed in 23%, and 36% of those patients had salvage esophagectomy. Median survival for those undergoing salvage esophagectomy was 59 mos, whereas pts who were not offered
August 31, 2014
In this retrospective study based on a database of 5390 patients with early-stage esophageal cancer, T1a and T1b lesions were treated by endoscopic (26.5%) or surgical resection (73.5%). For patients undergoing surgery, the incidence of lymph node metastasis was 5.0% for T1a and 16.6% for T1b lesions.
August 9, 2014
This randomized trial involving 30 centers in France compared outcomes after induction chemoradiotherapy followed by resection to resection alone for stage I or II esophageal cancer. The R0 resection rate was similar between the groups. Postoperative mortality was higher in the induction therapy group (11.1% vs 3.4%). Long-term survival was simila
July 28, 2014
The efficacy of induction therapy for clinical T2 esophageal cancer was evaluated using the National Cancer Database. Pretreatment staging was accurate in only 27% of pts. 42% of pts were upstaged and 32% were downstaged. Induction therapy had no survival benefit.
July 28, 2014
This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base. Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers. Nodal involvement was predicted by T status, tumor size >2cm, and tu
July 12, 2014
Volume-outcomes relationships for operative mortality were first identified more than a decade ago. This study updated the data using Medicare claims for more than 3 million patients. The inverse relationship between volume and outcomes was confirmed for all 8 procedures studied. The inverse ratio actually increased for 5 of 8 procedures despite o