Modern oncological and operative outcomes in oesophageal cancer : the St. James's hospital experience
BACKGROUND: Oesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center.
METHODS: All patients undergoing surgery or multimodal therapy with curative intent from 2009 to 2018 were studied. All data was recorded prospectively and maintained internally. The period 2009-2013 was compared with 2014-2018 to monitor any change in trends.
RESULTS: Four hundred and seventy-five patients (adenocarcinoma 77%, mean age 65; 76% male; 64% neoadjuvant therapy) underwent open surgical resection, 54% via en bloc 2-stage, 19.8% en bloc 3-stage, and 26.5% by a transhiatal approach. New onset atrial fibrillation was the commonest index complication, in 108 (22.7%), 80 (18%) developed suspected pneumonia/respiratory tract infection, 20 (4.2%) an anastomotic leak, and 25 (5.2%) a chyle leak. The 90-day mortality rate was 1.2% and 0.8% at 30 days. The median survival was 77.17 months, with a 5-year survival of 56%.
CONCLUSION: Consistent with registry data on population survival for oesophageal cancer, this study highlights markedly improved survival outcomes in patients treated curatively, reflecting international trends, as well as low mortality rates; however, cardiorespiratory complications remain significant.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:190 |
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| Enthalten in: |
Irish journal of medical science - 190(2021), 1 vom: 21. Feb., Seite 297-305 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Donlon, Noel E [VerfasserIn] |
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| Links: |
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| Themen: |
Anastomotic leak |
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| Anmerkungen: |
Date Completed 08.03.2021 Date Revised 08.03.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11845-020-02321-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM312724330 |
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| 100 | 1 | |a Donlon, Noel E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modern oncological and operative outcomes in oesophageal cancer |b the St. James's hospital experience |
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| 500 | |a Date Revised 08.03.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Oesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center | ||
| 520 | |a METHODS: All patients undergoing surgery or multimodal therapy with curative intent from 2009 to 2018 were studied. All data was recorded prospectively and maintained internally. The period 2009-2013 was compared with 2014-2018 to monitor any change in trends | ||
| 520 | |a RESULTS: Four hundred and seventy-five patients (adenocarcinoma 77%, mean age 65; 76% male; 64% neoadjuvant therapy) underwent open surgical resection, 54% via en bloc 2-stage, 19.8% en bloc 3-stage, and 26.5% by a transhiatal approach. New onset atrial fibrillation was the commonest index complication, in 108 (22.7%), 80 (18%) developed suspected pneumonia/respiratory tract infection, 20 (4.2%) an anastomotic leak, and 25 (5.2%) a chyle leak. The 90-day mortality rate was 1.2% and 0.8% at 30 days. The median survival was 77.17 months, with a 5-year survival of 56% | ||
| 520 | |a CONCLUSION: Consistent with registry data on population survival for oesophageal cancer, this study highlights markedly improved survival outcomes in patients treated curatively, reflecting international trends, as well as low mortality rates; however, cardiorespiratory complications remain significant | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anastomotic leak | |
| 650 | 4 | |a Oesophageal adenocarcinoma | |
| 650 | 4 | |a Oesophageal cancer incidence | |
| 650 | 4 | |a Oesophageal squamous cell carcinoma | |
| 650 | 4 | |a Oesophageal surgery complications | |
| 650 | 4 | |a Oncological outcomes | |
| 700 | 1 | |a Ravi, Narayanasamy |e verfasserin |4 aut | |
| 700 | 1 | |a King, Sinead |e verfasserin |4 aut | |
| 700 | 1 | |a Cunninhgam, Moya |e verfasserin |4 aut | |
| 700 | 1 | |a Cuffe, Sinead |e verfasserin |4 aut | |
| 700 | 1 | |a Lowery, Maeve |e verfasserin |4 aut | |
| 700 | 1 | |a Wall, Carmel |e verfasserin |4 aut | |
| 700 | 1 | |a Hughes, Niall |e verfasserin |4 aut | |
| 700 | 1 | |a Muldoon, Cian |e verfasserin |4 aut | |
| 700 | 1 | |a Ryan, Ciara |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Jenny |e verfasserin |4 aut | |
| 700 | 1 | |a O'Farrell, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Gorry, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Duff, Ann-Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Enright, Cathy |e verfasserin |4 aut | |
| 700 | 1 | |a Nugent, Tim S |e verfasserin |4 aut | |
| 700 | 1 | |a Elliot, Jessie A |e verfasserin |4 aut | |
| 700 | 1 | |a Donohoe, Claire L |e verfasserin |4 aut | |
| 700 | 1 | |a Reynolds, John V |e verfasserin |4 aut | |
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