scholarly journals P-OGC87 Robotic Techniques in Esophagogastric Cancer Surgery: An Assessment of Short- and Long-term Clinical Outcomes

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Sivesh Kamarajah ◽  
Ewen Griffiths ◽  
Alexander Phillips ◽  
Jelle Ruurda ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
High Volume ◽  
The United States ◽  
Cancer Surgery ◽  
Phase Iii ◽  
Term Survival ◽  
Long Term Survival ◽  
Gastric Cancers ◽  
Tumor Stages ◽  
Esophagogastric Cancer

Abstract Background Robotic esophagogastric cancer surgery is gaining widespread adoption. This population-based cohort study aimed to compare rates of textbook outcomes (TO) and survival from robotic minimally invasive techniques for esophagogastric cancers. Methods Data from the United States National Cancer Database (NCDB) (2010-2017), was used to identify patients with non-metastatic esophageal and gastric cancers receiving open (esophagus, n = 11,442; stomach, n = 22,183), laparoscopic (esophagus (LAMIE), n = 4,827; stomach (LAMIG), n = 6,359) or robotic (esophagus (RAMIE), n = 1,657; stomach (RAMIG), n = 1,718) surgery. TO were defined as lymph nodes examined >15, margin-negative resections, length of stay <21 days, no 30-day readmission, and no 90-day mortality. Multivariable logistic regression and Cox analyses were used to account for treatment selection bias. Results Patients receiving robotic surgery were more commonly treated within high volume, academic centers and with advanced clinical T and N stage disease. From 2010 to 2017, TO rates increased for esophageal and gastric cancer treated by all surgical techniques. RAMIE (odds ratio (OR):1.41, (CI 95% : 1.27-1.58) and RAMIG (OR:1.30, CI 95% : 1.17-1.45) had significantly higher TO rates compared to open surgery. For esophagectomy, TO (hazard ratio (HR):0.64, CI 95% : 0.60-0.67) and RAMIE (HR:0.92, CI 95% : 0.84-1.00) were both associated with long-term survival. For gastrectomy, TO (HR:0.58, CI 95% : 0.56-0.60) and both LAMIG (HR:0.89, CI 95% : 0.85-0.94) and RAMIG (HR:0.88, CI 95% : 0.81-0.96) were all associated with long-term survival. Subset analysis in high volume centers confirmed similar findings. Conclusions Despite potentially adverse learning curve effects and more advanced tumor stages captured within the study period, both RAMIE and RAMIG, as performed in mostly high-volume centers, were associated with improved TO and long-term survival. Therefore, consideration for wider adoption but a well-designed phase III RCT is required to fully evaluate the benefits of robotic techniques in esophageal and gastric cancers.

scholarly journals Robotic Techniques in Esophagogastric Cancer Surgery: An Assessment of Short- and Long-Term Clinical Outcomes

2021 ◽  
Author(s):  
Sivesh K. Kamarajah ◽  
Ewen A. Griffiths ◽  
Alexander W. Phillips ◽  
Jelle Ruurda ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Robotic Surgery ◽  
Open Surgery ◽  
High Volume ◽  
The United States ◽  
Cancer Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Esophagogastric Cancer

Abstract Background Robotic esophagogastric cancer surgery is gaining widespread adoption. This population-based cohort study aimed to compare rates of textbook outcomes (TOs) and survival from robotic minimally invasive techniques for esophagogastric cancer. Methods Data from the United States National Cancer Database (NCDB) (2010–2017) were used to identify patients with non-metastatic esophageal or gastric cancer receiving open surgery (to the esophagus, n = 11,442; stomach, n = 22,183), laparoscopic surgery (to the esophagus [LAMIE], n = 4827; stomach [LAMIG], n = 6359), or robotic surgery (to the esophagus [RAMIE], n = 1657; stomach [RAMIG], n = 1718). The study defined TOs as 15 or more lymph nodes examined, margin-negative resections, hospital stay less than 21 days, no 30-day readmissions, and no 90-day mortalities. Multivariable logistic regression and Cox analyses were used to account for treatment selection bias. Results Patients receiving robotic surgery were more commonly treated in high-volume academic centers with advanced clinical T and N stage disease. From 2010 to 2017, TO rates increased for esophageal and gastric cancer treated via all surgical techniques. Compared with open surgery, significantly higher TO rates were associated with RAMIE (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.27–1.58) and RAMIG (OR 1.30; 95% CI 1.17–1.45). For esophagectomy, long-term survival was associated with both TO (hazard ratio [HR 0.64, 95% CI 0.60–0.67) and RAMIE (HR 0.92; 95% CI 0.84–1.00). For gastrectomy, long-term survival was associated with TO (HR 0.58; 95% CI 0.56–0.60) and both LAMIG (HR 0.89; 95% CI 0.85–0.94) and RAMIG (HR 0.88; 95% CI 0.81–0.96). Subset analysis in high-volume centers confirmed similar findings. Conclusion Despite potentially adverse learning curve effects and more advanced tumor stages captured during the study period, both RAMIE and RAMIG performed in mostly high-volume centers were associated with improved TO and long-term survival. Therefore, consideration for wider adoption but a well-designed phase 3 randomized controlled trial (RCT) is required for a full evaluation of the benefits conferred by robotic techniques for esophageal and gastric cancers.

scholarly journals Long-term Survival of Dialysis Patients With Bacterial Endocarditis Undergoing Valvular Replacement Surgery in the United States

Circulation ◽  
2013 ◽  
Vol 128 (4) ◽  
pp. 344-351 ◽  
Author(s):  
Maxwell D. Leither ◽  
Gautam R. Shroff ◽  
Shu Ding ◽  
David T. Gilbertson ◽  
Charles A. Herzog
Keyword(s):  
United States ◽  
The United States ◽  
Bacterial Endocarditis ◽  
Dialysis Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Replacement Surgery ◽  
Valvular Replacement

scholarly journals Statin therapy and its association with long-term survival after colon cancer surgery

Surgery ◽  
2021 ◽  
Author(s):  
Arvid Pourlotfi ◽  
Rebecka Ahl Hulme ◽  
Maximilian Peter Forssten ◽  
Gabriel Sjolin ◽  
Gary A. Bass ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Statin Therapy ◽  
Cancer Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Colon Cancer Surgery

Su1285 Long-Term Survival of Patients With Transplant-Eligible Hepatocellular Carcinoma (HCC) in Post-MELD Exception Era in the United States Between 2004 and 2007

2013 ◽  
Vol 144 (5) ◽  
pp. S-447-S-448
Author(s):  
Pardha Devaki ◽  
Vidyasagargoud Marupakula ◽  
Sharad Nangia ◽  
Basile Njei ◽  
Ivo C. Ditah ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
The United States ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Comparison of Long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis

2020 ◽  
Author(s):  
Yun Xu ◽  
Cong Li ◽  
Charlie Zhi-Lin Zheng ◽  
Yu-Qin Zhang ◽  
Tian-An Guo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Control Group ◽  
Sporadic Colorectal Cancer ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Tumor Stages

Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare,with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year OS rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (p = 0.029). The 5-year PFS rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; p = 0.262). The 5-year TFS rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (p = 0.039). By multivariate analysis, we found that tumor progression of primary CRC and TNM staging were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients. Strict regular follow-up monitoring, detection at earlier tumor stages, and effective treatment are key to ensuring better long-term prognosis.

Sign in / Sign up

Export Citation Format

Share Document