scholarly journals IDDF2019-ABS-0056 Minimally invasive esophagectomy after neoadjuvant chemoradiotherapy using CROSS regimen for locally advanced esophageal cancer

2019 ◽  
Author(s):  
Kalayarasan Raja
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Esophageal Cancer ◽  
Invasive Esophagectomy ◽  
Locally Advanced Esophageal Cancer

P29 COMPARISON BETWEEN MINIMALLY INVASIVE AND OPEN ESOPHAGECTOMY IN PATIENTS AGED ≥75 YEARS: A NATIONWIDE PROPENSITY-SCORE MATCHED COHORT STUDY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Baranov Nikolaj ◽  
Claassen Linda ◽  
van Workum Frans ◽  
Rosman Camiel
Keyword(s):  
Esophageal Cancer ◽  
Cohort Study ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Locally Advanced ◽  
Advanced Esophageal Cancer ◽  
Perioperative Mortality ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Locally Advanced Esophageal Cancer

Abstract Aim To compare postoperative outcome in elderly undergoing either open or minimally invasive esophagectomy. Background & Methods Randomized controlled trials have shown improved short term outcome in patients undergoing minimally invasive compared with open esophagectomy. However, all of them have excluded patients aged 75 years or older. Evidence regarding this patient group, therefore, remains scarce. A propensity score matched retrospective cohort study was performed in a Dutch nationwide cohort from the period of april 2011 to april 2016 of patients aged ≥75 years diagnosed with local and locally advanced esophageal cancer who underwent either minimally invasive or open esophagectomy. Primary outcomes consisted of anastomotic leakage and perioperative mortality. Secondary outcomes were the rate of other complications, reintervention and hospital/ICU readmission. Results After matching, 322 patients were included, 161 in the open esophagectomy and 161 in the minimally invasive esophagectomy group. In the minimally invasive group, a significantly higher incidence occurend of Clavien-Dindo ≥3 complications (RR 1.63, CI-95% 1.24—2.13), anastomotic leaks (RR 1.60, CI-95% 1.12—2.29) and reinterventions (RR 1.70, CI-95% 1.19—2.42). There were no significant differences regarding perioperative mortality, other complications and readmission rate. Conclusion Elderly patients diagnosed with locally advanced esophageal cancer should undergo minimally invasive esophagectomy in favor of open esophagectomy. Keywords Elderly, minimally invasive esophagectomy, open esophagectomy, esophageal cancer, clinical outcome, perioperative mortality.

Trimodality treatment for advanced esophageal cancer: Impact of minimally invasive esophagectomy.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 125-125
Author(s):  
D. G. Williams ◽  
S. Carpenter ◽  
H. J. Ross ◽  
H. Paripati ◽  
J. B. Ashman ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Residual Disease ◽  
Minimally Invasive Esophagectomy ◽  
Gastroesophageal Junction ◽  
Locally Advanced ◽  
Operating Time ◽  
Advanced Esophageal Cancer ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

125 Background: Esophageal cancer is best managed by multimodality therapy, frequently with chemotherapy (C) or chemo- radiotherapy (CRT) preceding resection. Minimally invasive esophagectomy (MIE) is increasingly accepted, but studies of MIE in advanced esophageal and gastroesophageal junction cancer after induction CRT are lacking. This report presents the data on MIE as part of tri-modality therapy for esophageal cancer at Mayo Clinic in Arizona (MCA). Methods: Patients (pts) who underwent CRT before or after MIE for cancer at MCA between November 2006 and May of 2010 were reviewed retrospectively. Results: 46 pts (40 males, and 6 females) met study criteria and were reviewed. Median age was 62 years (41-88 years). 45 pts (98%) had adenocarcinoma and one pt had squamous carcinoma. Initial clinical stage was IIA in 10 pts (22%), IIB in 3 pts (7%), III in 26 pts (55%), and IVA in 7 pts (15%) with positive celiac nodes. 43 pts (93%) underwent preoperative CRT with additional intra-operative radiotherapy in 4 pts. Median operating time was 354 min (range 211-567 min), median blood loss was 225 ml (range 50-1,400 ml), and median hospital stay was 8 days (range 5-48 days). 19 pts (41%), including the 3 who did not undergo preoperative CRT, received postoperative C or CRT due to either residual disease at resection or to local recurrence. 30 of 43 pts undergoing MIE after CRT were down staged (11 CR [25.6%], 10 near CR [23.3%]) demonstrating a major response to neoadjuvant therapy in 48.9% of pts. One pt died in hospital (from ARDS and sepsis subsequent to aspiration pneumonia) and two pts died within 30 days of surgery (one from pulmonary embolism, and the other from unknown causes) for a 30 day surgical mortality of 6.5%. 29 pts (63%) had a complication of surgery including 11 (24%) minor and 18 (39%) major complications. After a median follow-up of 13 months (range 0.9-43 months) 16 pts were diagnosed with recurrent disease and 10 of these pts have died of their disease. Conclusions: CRT with MIE is associated with an acceptable morbidity and mortality level for pts with locally advanced esophageal cancer. These results compare favorably with morbidity, mortality, and recurrence rates in open esophagectomy pts. No significant financial relationships to disclose.

PS02.016: MINIMALLY INVASIVE ESOPHAGECTOMY IN ESOPHAGEAL CANCER: EXPERIENCE IN THE FIRST 100 CASES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 124-125
Author(s):  
Atila Eroglu ◽  
Coskun Daharli ◽  
Yener Aydin ◽  
Ali Ulas ◽  
Haci Alici
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Cell Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Thoracoscopic Esophagectomy ◽  
Invasive Esophagectomy ◽  
The Mean

Abstract Background In this study, the efficiency of minimally invasive esophagectomy in esophageal cancer was examined. Methods A total of 100 consecutive patients who were hospitalized due to esophageal cancer and planned minimally invasive esophagectomy were evaluated prospectively between September 2013 and December 2017 in our clinic. Laparoscopic and thoracoscopic esophagectomy was performed in all of the patients included in the study. Inoperable cases were not included in the study. Age and sex of the patients, symptoms, localization of tumor, histopathological type, surgical modality, operation time, length of hospital stay and morbidity and mortality rates were reviewed. Results Thirty-eight (38%) patients were male and 62 (62%) patients were female. The mean age was 55.5 ± 10.8 (32–75 years). The most symptoms were dysphagy (96%) and weight loss (39%). Eighty-one patients (81%) had squamous cell cancer, ten (10%) had adenocarcinoma and nine had another form of esophageal cancer. Neoadjuvant chemoradiotherapy was performed in 36 of the 100 patients. Laparoscopic and thoracoscopic esophagectomy and intrathoracic anastomosis were performed in 94 patients (94%). Laparoscopic and thoracoscopic esophagectomy and neck anastomosis were performed in six patients (6%). The mean duration of operation was 260.1 ± 33.4 minutes (185–335 minutes). The mean intraoperative blood loss was 114.2 ± 191.4 ml (10–800 ml). In 51 (51%) of the patients, complications occurred in perioperative, early postoperative and late postoperative periods. In postoperative complications, anastomotic leak rate was eight patients (8%) and pulmonary complication rate was 21 patients (21%). While mortality was seen in three patients that had diabetes mellitus and hypertension, the 30-day mortality was 2% and the hospital mortality was 3%. The mean hospital stay was 11.2 ± 8.3 days (range 8–44). In our study, the probability of one-year overall survival was 91% and the probability of two years overall survival was 66%. Conclusion Minimally invasive esophagectomy is a safe and preferred method with low mortality, acceptable morbidity, short operative time and short hospital stay and has become a routine approach in the treatment of esophageal cancers. Multicenter studies to be performed in the near future will further assist in defining the benefits of minimally invasive esophagectomy. Disclosure All authors have declared no conflicts of interest.

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