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Esophagus

November 11, 2014
This study explored financial conflicts of interest (FCOI) among authors of published guidelines and consensus statements and their relationship to endorsement of specific drugs.  93% of recent articles reported FCOI status.  Of articles publishing funding sources, 65% reported partial or full industry funding.  Endorsement of chemotherapeutic agents
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
October 8, 2014
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
October 8, 2014
The histologic response to induction therapy is usually a binary function.  In the current study, the authors explored methods of refining the histologic response classification to improve prediction of prognosis for patients with esophageal adenocarcinoma.  They identified 3 unique groups: major response in the primary tumor with ypN0; either major
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 25, 2014
This retrospective review evaluated the relationship of pretreatment vs post-induction therapy stage to survival in patients undergoing surgery for esophageal adenocarcinoma in 2 centers in London.  Among 584 pts, 400 underwent induction therapy.  Downstaging predicted improved survival (HR 0.43).  Downstaging was associated with decreased rates of l
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

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