Preoperative 3D-CT evaluation of the bronchial arteries in transmediastinal radical esophagectomy for esophageal cancer

Abstract High MCV is suggested to be relevant to the incidence and prognosis of several malignancies. However, few studies investigating the correlation between MCV and survival outcome of esophageal cancer have been conducted. Methods This study included 570 patients with esophageal cancer who underwent radical esophagectomy between April 2005 and December 2017. Patients were divided into two groups according to the standard value of pretreatment MCV: normal (83–99 fL) and high (>99 fL) groups. Clinical backgrounds, short-term outcomes, and prognostic outcomes post-esophagectomy were retrospectively compared between the groups. Results Of all patients, 410 (71.9%) had normal MCV, and 160 (28.1%) had high MCV. High MCV was significantly associated with lower body mass index, higher frequency of habitual alcohol and tobacco use, and higher incidence of multiple primary malignancies other than esophageal cancer. High MCV also correlated with higher incidence of postoperative morbidity of the Clavien–Dindo classification ≥II and pulmonary morbidity. Overall survival was significantly worse in patients with high MCV. Multivariate analysis suggested that high MCV was an independent risk factor for worse survival outcome (hazard ratio, 1.54; 95% confidence interval, 1.098–2.151; p = 0.012). Conclusion Patients with high MCV have various disadvantages in clinical background that can adversely affect both short-term and long-term outcomes after esophagectomy. MCV can become a predictive marker to estimate survival outcome after esophagectomy for esophageal cancer.

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PS02.238: POSTOPERATIVE PROGNOSTIC NUTRITIONAL INDEX CAN PREDICT A LONG-TERM PROGNOSIS OF ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.238 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 189-190

Author(s):

Jun Takahashi ◽

Masaaki Saito ◽

Tamotsu Obitsu ◽

Daisuke Ishioka ◽

Hirokazu Kiyozaki ◽

...

Keyword(s):

Esophageal Cancer ◽

Conflicts Of Interest ◽

Prognostic Nutritional Index ◽

Pathological Stage ◽

Radical Esophagectomy ◽

Esophagus Cancer ◽

Nutritional Index ◽

Long Term Prognosis ◽

Advanced Pathological Stage

Abstract Background Recent reports indicate the nutritional and immune status often affect the long-term prognosis of patients with cancer. The preoperative prognostic nutritional index(PNI) is used as an evaluation of the perioperative nutritional status, and it is reported that the PNI level correlates with postoperative results. However, only a handful of reports have discussed the predictive prognostic potential of postoperative PNI. The aim of this study is to clarify the correlation of postoperative PNI level and long-term prognosis of patients with esophagus cancer who underwent esophagectomy. Methods A total of 29 patients with esophageal cancer who received neoadjuvant chemotherapy followed by radical esophagectomy from January 2011 to December 2014 were retrospectively reviewed. The calculation of PNI level is as follows: 10 × serum albumin level (g/dL) + 0.005 × total lymphocyte count (/mm3). The postoperative PNI level was measured three months after radical esophagectomy. The patients were stratified by postoperative PNI level by two groups using calculated cutoff level (PNI = 43.9) by receiver operating characteristic curve. The correlation of 3-year disease-free survival (DFS) and postoperative PNI level was evaluated. Results Of the total, 25 were male and 4 were female. The median age of patients was 68 years (31–79 years). Overall, patients received 1–2 cycles of preoperative chemotherapy with 5-FU and cisplatin. Of these 29 patients, 9 (31.0%) responded to chemotherapy (8 patients had a partial response and 1 had a complete response). The median postoperative PNI level was 47.2 (38.0–58.9). Univariate analyses showed that 3-year DFS was worse in patients with low postoperative PNI level (P = 0.017), advanced pathological stage (P = 0.029) and younger age (< 70 years) (P = 0.02). Multivariate analyses showed that low postoperative PNI level[hazard ratio (HR) 0.224, 95% confidence interval (CI) 0.060–0.83, P = 0.026] and advanced pathological stage (HR 3.197, 95% CI 1.13–9.06, P = 0.029) were independent predictors of 3-year DFS. Conclusion Our findings suggest that the postoperative PNI level may be a useful marker to predict a prognosis of patients with esophagus cancer. Nutrition intervention for undernourished patients after surgery may improve prognosis of patients with esophagus cancer. Disclosure All authors have declared no conflicts of interest.

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Efficacy and Safety of Continuous Paravertebral Block after Minimally Invasive Radical Esophagectomy for Esophageal Cancer

Pain Research and Management ◽

10.1155/2020/3105874 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Shifa Zhang ◽

Hongfeng Liu ◽

Haibo Cai

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Adverse Reactions ◽

Postoperative Recovery ◽

Pulmonary Complications ◽

Paravertebral Block ◽

Radical Esophagectomy ◽

Visual Analogue Pain ◽

Intravenous Analgesia ◽

Vas Scores

Objective. To compare the effects of continuous paravertebral block analgesia and patient-controlled intravenous analgesia after minimally invasive radical esophagectomy for esophageal cancer and their effects on postoperative recovery. Methods. A retrospective analysis was performed among 233 patients who underwent minimally invasive esophageal cancer radical operation and met the requirements, including 87 patients (group C) who were successfully placed with a continuous paravertebral block device under direct vision and 146 patients (group P) who used a patient-controlled intravenous analgesia device. Visual analogue pain score (VAS) at rest and in motion for 1, 3, 6, 12, 24, 36, and 48 hours after awakening, incidence of adverse reactions of the two analgesic methods, occurrence of pulmonary complications after operation, use of emergency analgesics, and hospital stay after operation was recorded. Results. The VAS scores of group C in resting and active state at 1, 3, 6, 12, 24, 36, and 48 hours after operation were significantly lower than those of group P (P<0.001). The incidence of adverse reactions, pulmonary complications, and the use of emergency analgesics in group C were lower than those in group P (P<0.05). The hospitalization time of group C was significantly shortened, and the satisfaction degree of group C was significantly higher than that of group P (P<0.05). Conclusion. Paravertebral block is safe and effective for patients undergoing minimally invasive radical esophagectomy. The incidence of adverse reactions and complications is lower, and the satisfaction of postoperative analgesia is higher, which is beneficial to the rapid recovery of patients after operation.

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Prognosis Impact of Postoperative Radiation in Patients with Radical Esophagectomy and Pathologic Lymph Nodes Positive Esophageal Cancer

Annals of Oncology ◽

10.1016/s0923-7534(20)33327-5 ◽

2012 ◽

Vol 23 ◽

pp. ix226

Author(s):

Y. Xu ◽

W. Mao ◽

X.J. Sun ◽

Y.D. Zheng ◽

Y. Jiang ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Nodes ◽

Postoperative Radiation ◽

Radical Esophagectomy

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Pulmonary Function During Exercise Before and After Radical Esophagectomy for Esophageal Cancer

Recent Advances in Diseases of the Esophagus ◽

10.1007/978-4-431-68246-2_167 ◽

1993 ◽

pp. 1010-1016

Author(s):

Fumikazu Maeda ◽

Masayuki Higashino ◽

Harushi Osugi ◽

Noriaki Maekawa ◽

Hiroaki Kinoshita

Keyword(s):

Esophageal Cancer ◽

Pulmonary Function ◽

Radical Esophagectomy ◽

Before And After

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Single-Port Inflatable Mediastinoscopy Combined With Laparoscopic-Assisted Small Incision Surgery for Radical Esophagectomy Is an Effective and Safe Treatment for Esophageal Cancer

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-018-04069-w ◽

2019 ◽

Vol 23 (8) ◽

pp. 1533-1540 ◽

Cited By ~ 1

Author(s):

Xiaojin Wang ◽

Xiaojian Li ◽

Hua Cheng ◽

Bin Zhang ◽

Hongcheng Zhong ◽

...

Keyword(s):

Esophageal Cancer ◽

Single Port ◽

Radical Esophagectomy ◽

Safe Treatment ◽

Small Incision ◽

Laparoscopic Assisted ◽

Small Incision Surgery

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O30 NON-RADICAL ESOPHAGECTOMY FOR ESOPHAGEAL CANCER; A NATIONWIDE STUDY ON INCIDENCE, RISK FACTORS AND OUTCOMES IN SWEDEN

Diseases of the Esophagus ◽

10.1093/dote/doz092.30 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

David Edholm ◽

Petter Hollertz ◽

Per Sandström ◽

Bergthor Björnsson ◽

Dennis Björk ◽

...

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Cox Regression ◽

Regional Lymph Node ◽

Neoadjuvant Treatment ◽

Resected Specimen ◽

Radical Esophagectomy ◽

Term Survival ◽

R1 Resection ◽

Independent Risk Factors

Abstract Aim To identify potential risk factors for a microscopically non-radical esophageal cancer resection (R1) and investigate how such a resection affects long-term survival. Background & Methods Esophageal cancer resections that are considered R1 have been associated with worse survival. The Swedish National Register for Esophageal and Gastric Cancer includes information on all esophageal cancer resections in Sweden. All patients having undergone esophageal resection with curative intent 2006-2017 were included. Risk factors for R1 resection were assessed through logistic regression. Factors predicting five-year survival were assessed through Cox-regression, adjusted for T-stage, N-stage, age and R-status. Results The study included 1,504 patients. The margins were microscopically involved in 146 patients (10%). Of these the circumferential margin was involved in 115 (8%). The proximal margin was involved in 55 patients (4%) and the distal in 30 (2%). In 54 (4%) specimens two margins were involved. Independent risk factors for R1-resection were absence of neoadjuvant treatment and clinical T3 stage or higher. The 5-year survival for the entire cohort was 41%, but only 19% for those with an R1 resection. Independent risk factors for death within 5-year from resection were regional lymph node metastasis (Hazard Ratio (HR) 2.6 (95% CI 2.2-3.1), histopathological stage T3 or higher (HR 1.2 95% CI 1.1-1.5), age above 60 years and R1-resection (HR 1.6 95% CI 1.4-2.0) Conclusion Involved margin in the resected specimen is an independent risk factor predicting worse 5-year survival. Besides striving for adequate surgical margins, the rate of R1-resections could be decreased through neoadjuvant treatment in fit patients.

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