RA09.06: LONG-TERM OUTCOMES OF 650 ESOPHAGEAL CANCER PATIENTS WITH THORACOSCOPIC ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 41-41
Author(s):  
Takahiro Heishi ◽  
Hirotaka Ishida ◽  
Yu Onodera ◽  
Ken Ito ◽  
Takuro Konno ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Conflicts Of Interest ◽  
Clinical Stage ◽  
Neoadjuvant Chemoradiotherapy ◽  
Thoracoscopic Esophagectomy ◽  
Stage Ii ◽  
Long Term Outcomes ◽  
Thoracoscopic Approach ◽  
Significant Difference

Abstract Background In 1996 Akaishi et al. reported the first thoracoscopic esophagectomy (TE) in Japan. Total 650 TEs for esophageal cancer have been performed in our institute by October 2016. There are many reports about the short-term outcomes of TE compared with open esophagectomy (OE), but the long-term outcomes of TE have been under debate. The aim of this study is to investigate the survival benefits of TE and to compare with OE and long-term outcomes which other previous reports showed. Methods A total 750 cases who underwent TE (N = 650) or OE (N = 100) between 1994 and 2015 in our hospital were included in this study. They were divided into four groups; surgery without any preoperative treatments (group S, N = 414), surgery after neoadjuvant chemotherapy (Group NAC, clinical stage II or III, N = 116), surgery after neoadjuvant chemoradiotherapy (Group NACRT, clinical stage II or III, N = 68) and salvage surgery after definitive chemoradiotherapy (Group SALV, N = 76). In group S, 100 patients received OE and 314 received TE. The other 3 groups (Group NAC, NACRT and SALV) received only TE. 3-year, 5-year overall survival (OS) and progression-free survival (PFS) rates for each group were analyzed and compared. Results In group S, the 5-year OS rate of TE was 63.4% and that of OE was 68.3%, there was no significant difference (Log-Rank test P = 0.41). Stage-specific OS rates of TE and OE were also compared and there was no significant difference. PFS rates of OE and TE showed the same tendency of OS. 5-year OS rate of group NAC was 63.5%. 3-year OS of group NACRT was 61.4%. 3-year and 5-year OS of group SALV were 41.4% and 34.0%. These results were the same or better than what the previous reports showed. Conclusion The long-term outcomes of TE were almost same as those of OE. The TE procedure resulted in similar or potentially better long-term outcomes in case of NAC, NACRT and SALV. It's acceptable to say thoracoscopic approach is the standard of esophagectomy. Disclosure All authors have declared no conflicts of interest.

Short- and long-term outcomes following laparoscopic gastrectomy for advanced gastric cancer compared with open gastrectomy.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 369-369
Author(s):  
Kazuaki Shibuya ◽  
Hideki Kawamura ◽  
Yosuke Ohno ◽  
Nobuki Ichikawa ◽  
Tadashi Yoshida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Clinical Stage ◽  
Stage Ii ◽  
Open Gastrectomy ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term

369 Background: To investigate the oncological feasibility and technical safety of laparoscopic gastrectomy with D2 lymphadenectomy for advanced gastric cancer. Methods: 186 advanced gastric cancer patients treated by gastrectomy with D2 lymphadenectomy were eligible for inclusion including those with invasion into the muscularis propria, subserosa, and serosa without involvement of other organs, and stages N0–2 and M0. We retrospectively compared the short- and-long term outcomes between laparoscopic gastrectomy and open gastrectomy. Results: We analyzed short-term outcomes by comparing distal- with total gastrectomy results. We found no significant difference for distal gastrectomy for postoperative morbidity (laparoscopic vs. open: n = 4 (4.6%) vs. n = 1 (3.6%); p= 1.00). We also found no significant difference in postoperative morbidity for total gastrectomy (laparoscopic vs. open: n = 2 (4.0%) vs. n = 1 (4.0%); p= 1.00). No deaths occurred in any group. The entire cohort analysis revealed no statistically significant differences in overall- or recurrence-free survival between the laparoscopic and open groups. For overall survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III ( p= 0.29 and 0.27, respectively), and for pathological stage II or III ( p= 0.88 and 0.86, respectively). For recurrence-free survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III ( p= 0.63 and 0.60, respectively), and for pathological stage II or III (p = 0.98 and 0.72, respectively). Conclusions: Laparscopic gastrectomy for advanced gastric cancer compared favorably with open gastrectomy regarding short- and long-term outcomes. Clinical trial information: 160907.

PS02.031: DEFINITIVE CHEMORADIOTHERAPY WITH DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL (DCF-R) FOR ADVANCED CERVICAL ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 128-129
Author(s):  
Hiroshi Okamoto ◽  
Yusuke Taniyama ◽  
Tadashi Sakurai ◽  
Takahiro Heishi ◽  
Chiaki Sato ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Clinical Stage ◽  
Stage Ii ◽  
Definitive Chemoradiotherapy

Abstract Background Recently, definitive chemoradiotherapy (dCRT) has become one of the essential treatment strategies for esophageal squamous cell carcinoma (ESCC) and has been especially gaining prevalence for cervical ESCC to preserve the larynx. There have been recent reports on favorable outcomes of docetaxel/CDDP/5-FU (DCF-R) for advanced esophageal cancer. Our department recently introduced DCF-R for treating advanced cervical ESCC. We analyzed the safety and outcomes of DCF-R in patients with advanced cervical ESCC. Methods We retrospectively evaluated 12 advanced cervical ESCC patients (clinical stage II–IV, including T4b and/or M1 lymph node) in our department who received DCF-R as the first-line treatment between December 2010 and February 2015. Results Our patient cohort comprised 9 males and 3 females (median age, 67.5 years; range: 54–76 years). All patients were squamous cell carcinoma. The median observation period was 34.5 (8–80) months with total irradiation dose of 64.0 (60–70) Gy. The pretreatment clinical stage (according to Union for International Cancer Center) included one stage II, seven stage III, and four stage IV cases (including 3 patients with T4b [2 trachea and 1 thyroid] and 4 patients with M1 lymph node. We attained complete response (CR) in 10 patients and stable disease in 2 patients. Of 10 patients with CR, 5 experienced recurrence and 5 continued exhibiting CR. Two persistent patients included one patient who died of cancer and one patient who underwent salvage surgery. Furthermore, grade 3 or more adverse events as defined in Common Terminology Criteria for Adverse Event version 4 included leucopenia (91.7%), neutropenia (91.7%), febrile neutropenia (50%), and pharyngeal pain (50%). There was no treatment-related mortality and treatment schedules were completed in all patients, although dose reduction of the second cycle of chemotherapy was required in four patients (33%) and change in the radiation schedule was required in one patient (8.3%). While the 2-/3-/5-year overall survival rate was 66.7%/48.6%/48.6%, the 2-/3-/5-year recurrent-free survival rate was 58.3%/50.0%/37.5%, respectively. Conclusion DCF-R treatment for advanced cervical ESCC could be completed by the careful administration, and although a strong blood toxicity might occur, a favorable prognosis can be obtained with larynx preservation. Disclosure All authors have declared no conflicts of interest.

Retrospective analysis of neoadjuvant chemoradiotherapy for esophageal cancer: The Knight Cancer Institute experience.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 126-126
Author(s):  
Faisal A Siddiqui ◽  
James P. Dolan ◽  
John G. Hunter ◽  
Miriam A. Douthit ◽  
Lisa M. Bloker ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Complete Remission ◽  
Early Stage ◽  
Clinical Stage ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Stage Ii ◽  
R0 Resection ◽  
Trimodality Therapy ◽  
Initial Staging

126 Background: Neoadjuvant chemoradiotherapy (NAT) followed by esophagectomy has been established as standard of care for early stage (II – III), resectable esophageal cancer (EC). Patients (pts) treated with NAT are more likely to be downstaged and have a complete (R0) resection. Additionally, pts with aggressive disease are more likely to progress during NAT and, consequently, avoid unnecessary surgery. The aim of the current report was to analyze the outcomes of trimodality therapy at the Knight Cancer Institute. Methods: A retrospective study of 124 pts who underwent NAT followed by esophagectomy for EC from 1999-2010 at our institution was performed. All pts were initially staged by imaging (EUS, CT and/or PET imaging) prior to commencing treatment. After esophagectomy, pathological staging was compared to initial staging to determine the effect of NAT. Results: There were 25 women and 99 men. Initial staging is shown in the table below. Patients received cisplatin, oxaliplatin or carboplatin with 5-FU plus concurrent radiotherapy (RT). RT total dose of 45 Gy to the tumor and regional nodes was given in 1.8 Gy daily fractions, followed by a boost to the tumor for final dose 50.4-54 Gy. 27 (21.8%) of the pts had a pathologic complete response. Additionally, 54 (43.6%) pts were downstaged by chemoradiation. Of the pts that had complete remission or were downstaged, pre-treatment clinical stage was Stage II (22 pts), Stage III (55 pts), and Stage IVa (4 pts). Conclusions: NAT was effective in complete remission or downstaging of two-thirds (81) pts, including 4 pts that were initially unresectable (Stage IVa) and successfully underwent subsequent esophagectomy. As has been shown previously, NAT is effective for downstaging prior to esophagectomy making it more likely that pts will undergo R0 resection. This study also demonstrated that some pts with clinically unresectable tumors could undergo successful esophagectomy after NAT. [Table: see text]

scholarly journals Study of neoadjuvant chemoradiotherapy with combined S-1 and low-dose cisplatin for patients with clinical stage II/III esophageal cancer

2018 ◽  
Vol 41 (2) ◽  
pp. 148-154
Author(s):  
Kodai Takahashi ◽  
Hideto Ito ◽  
Masatoshi Hashimoto ◽  
Kazuhito Mita ◽  
Hideki Asakawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Low Dose ◽  
Clinical Stage ◽  
Neoadjuvant Chemoradiotherapy ◽  
Stage Ii

Long-term Outcomes of Laparoscopic Versus Open Surgery for Clinical Stage II/III Gastric Cancer

2019 ◽  
Vol 269 (5) ◽  
pp. 887-894 ◽  
Author(s):  
Takahiro Kinoshita ◽  
Ichiro Uyama ◽  
Masanori Terashima ◽  
Hirokazu Noshiro ◽  
Eishi Nagai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Open Surgery ◽  
Clinical Stage ◽  
Stage Ii ◽  
Long Term Outcomes

Prediction of the long-term outcomes associated with body mass index and advanced gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 82-82
Author(s):  
Jae Gyu Kim ◽  
Beom Jin Kim ◽  
Kyong-Choun Chi ◽  
Jung Min Park ◽  
Mi Kyoung Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Mass Index ◽  
Advanced Gastric Cancer ◽  
Body Mass ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Stage Iii ◽  
Long Term Outcomes ◽  
Significant Difference

82 Background: Radical gastrectomy followed by adjuvant chemotherapy for advanced gastric cancer brings about serious nutritional impairment. Recent studies have shown an association between body mass index (BMI) and perioperative outcomes of gastric cancer. However, little is known about the association between BMI and long-term outcomes of advanced gastric cancer. Our study evaluated the clinical impact of BMI on the long-term outcomes of gastric cancer staged at II and III, treated by radical gastrectomy followed by adjuvant chemotherapy. Methods: We analysed a total of 211 cases of advanced gastric cancer stage II and III between January 2005 and December 2010 at Chung-Ang University Hospital. The patients were divided into 4 groups according to BMI; underweight, normal, overweight, and obese. In addition, they were divided into two groups (BMI-High vs BMI-Low). We assessed age, sex, tumor location, lymph node involvement, operation method, initial cancer stage, recurrence, and survival (overall survival and disease free survival) between two groups. Results: We classified them into 4 groups according to BMI; underweight, normal, overweight, and obese. There was no difference in overall survival between normal, overweight, and obese group. However, there was significant difference between underweight group and the other groups. As for disease free survival, similar findings were observed. Among 211 patients, 154 patients (72.9%) were included in BMI-L (body mass index < 25), whereas 57 patients (27.1%) in BMI-H (body mass index ≥ 25). There was no difference in age, sex, tumor location, stage, lymph node involvement, operation method, recurrence, and cancer-related death between two groups. When classified into 4 groups as stage II in BMI-H, stage II in BMI-L, stage III in BMI-H, and stage III in BMI-L, overall survival showed significant difference in stage, however, no difference between BMI-H and BMI-L. Disease free survival showed no significant difference in stage and BMI, especially, no significant difference between stage II in BMI-L and stage III in BMI –H. Conclusions: Our findings suggest that preoperative BMI may predict the long term outcomes of advanced gastric cancer after radical surgery and chemotherapy.

Surgically treated esophageal cancer developed in a radiated field: Impact on peri-operative and long-term outcomes.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 150-150
Author(s):  
Christophe Mariette ◽  
Sheraz Markar ◽  
Caroline Gronnier ◽  
Arnaud Pasquer ◽  
Alain Duhamel ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathological Stage ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Margin Involvement ◽  
Before And After ◽  
Baseline Characteristics ◽  
Surgery Outcomes

150 Background: The objectives of this study were to compare peri-operative and long-term outcomes from esophageal cancer (EC) (i) that arose in a previously radiated field (ECRF) versus primary (PEC) and among ECRF patients (ii) radiotherapy-induced (RIEC) versus non radiotherapy-induced EC (NRIEC). Methods: Data was collected from 30 European centers from 2000–2010. 2489 EC patients surgically treated were included in the PEC group and 136 in the ECRF group, including 61 in the NRIEC group and 75 in the RIEC group. Propensity score matching analyses were used to compensate for differences in baseline characteristics. Results: Compared to the PEC group, the ECRF group was characterized by less use of neoadjuvant chemoradiotherapy (0% vs. 29.5%; P < 0.001), less pathological stage III/IV (31.6% vs 39.2%, P = 0.036), greater incidence of R1/2 margins (21.3% vs. 10.9%; P < 0.001), increased in-hospital mortality (14.0% vs. 7.1%; P = 0.003) and overall morbidity (68.4% vs. 56.4%, P = 0.006). After matching, 5-year overall (28.8% vs. 50.5%; HR = 1.53, 95% C.I. 1.15-2.04; P = 0.003) and event-free (32.2% vs. 42.5%; HR = 1.56, 95% C.I. 1.18-2.05; P = 0.002) survivals were significantly reduced in the ECRF group. There were no significant differences in incidence or pattern of tumor recurrence. Comparing RIEC and NRIEC groups, there were no significant differences in short- or long-term outcomes before and after matching. Conclusions: ECRF is associated with poorer long-term survival related to a reduced utilization of neoadjuvant chemoradiotherapy and an increased incidence of tumor margin involvement at surgery. Outcomes are dictated by the limitations related to previous radiotherapy administration more than the radiotherapy-induced carcinogenesis.

PS01.210: VIDEO-ASSISTED SALVAGE ESOPHAGECTOMY: SHORT- AND LONG-TERM OUTCOMES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 109-109
Author(s):  
Toshiaki Shichinohe ◽  
Soichi Murakami ◽  
Yuma Ebihara ◽  
Yo Kurashima ◽  
Satoshi Hirano
Keyword(s):  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Conflicts Of Interest ◽  
Salvage Surgery ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Long Term Outcomes ◽  
Video Assisted ◽  
Salvage Esophagectomy ◽  
Short And Long Term

Abstract Background Salvage surgery is only one therapeutic option which enable to cure intractable esophageal cancer after definitive chemo-radiotherapy. Although video-assisted esophagectomy (VAE) is now widely accepted as a standard operation for primary esophageal cancer, the application of VAE to salvage surgery is still controversial since salvage surgery is known as high-risk operation. In this study, we investigated 27 cases of salvage surgery and assessed the feasibility of the operation by analyzing their short and long-term outcomes. Methods VAE was applied to 26 cases and laparoscopic lymphadenectomy was applied to 1 case. The procedure of the VAE included prone position esophagectomy (n = 8), esophagectomy by hand-assisted thoracoscopic surgery (n = 10) and mediastinoscope-assisted transhiatal esophagectomy (n = 5). Our current operative procedure after year 2010 is PPE. The fields of lymph node dissection for salvage esophagectomy have been limited to the stations that had metastasis before CRT and the lymphatic stations which newly recognized as suspected metastasis. Postoperative complications were defined according to the Clavien-Dindo classification. Results Video assisted surgery was applied to 96% of patients including one case of laparoscopic abdominal lymphadenectomy. One case required open surgery for suspicious of direct invasion of tumor. R0 rate of the operations was scored 78%. Postoperative complication rate defined as ≥ C-D II plus any grade of anastomotic leakage and recurrent laryngeal nerve palsy was 63%. The rate of anastomotic leakage, respiratory complication, and RLN palsy were 23%, 15%, and 12%, respectively. Operative death was 0%, whereas in-hospital mortality was 3.7%. Overall survival of esophagectomy cases showed 24% in 3-year and 8% in 5-year. According to subgroup analysis by pathological R status after operation, the survival outcomes of pR0 group (n = 20) reached 32% in 3-year and 10% in 5-year OS, whereas no patient reached 3-year survival in pR1/2 group (n = 6; P = 0.02). Conclusion Although salvage VAE should be applied in high-experienced institutions under the careful consideration of indication, it appears to be balanced operation for safety, and less invasiveness, as well as curability. Disclosure All authors have declared no conflicts of interest.

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