scholarly journals Surgical and Surgeon-Related Factors Related to Long-Term Survival in Esophageal Cancer: A Review

2019 ◽  
Vol 27 (3) ◽  
pp. 718-723 ◽  
Author(s):  
Sheraz R. Markar ◽  
Jesper Lagergren
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Critical Role ◽  
Survival Rates ◽  
Surgical Approaches ◽  
Related Factors ◽  
Term Survival ◽  
Long Term Survival ◽  
The Individual

Abstract Esophagectomy is the mainstay of curative treatment for most patients with a diagnosis of esophageal cancer. This procedure needs to be optimized to secure the best possible chance of cure for these patients. Research comparing various surgical approaches of esophagectomy generally has failed to identify any major differences in long-term prognosis. Comparisons between minimally invasive and open esophagectomy, transthoracic and transhiatal approaches, radical and moderate lymphadenectomy, and high and moderate hospital volume generally have provided only moderate alterations in long-term survival rates after adjustment for established prognostic factors. In contrast, some direct surgeon-related factors, which remain independent of known prognostic factors, seem to influence the long-term survival more strongly in esophageal cancer. Annual surgeon volume is strongly prognostic, and recent studies have suggested the existence of long surgeon proficiency gain curves for achievement of stable 5-year survival rates and possibly also a prognostic influence of surgeon age and weekday of surgery. The available literature indicates a potentially more critical role of the individual surgeon’s skills than that of variations in surgical approach for optimizing the long-term survival after esophagectomy for esophageal cancer. This finding points to the value of paying more attention to how the skills of the individual esophageal cancer surgeon can best be achieved and maintained. Careful selection and evaluation of the most suitable candidates, appropriate and structured training programs, and regular peer-review assessments of experienced surgeons may be helpful in this respect.

scholarly journals Genetic Alterations in Patients With Esophageal Cancer With Short- and Long-Term Survival Rates After Curative Esophagectomy

1997 ◽  
Vol 226 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Yutaka Shimada ◽  
Masayuki Imamura ◽  
Ichio Shibagaki ◽  
Hisashi Tanaka ◽  
Tokiharu Miyahara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rates ◽  
Genetic Alterations ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term ◽  
Curative Esophagectomy

scholarly journals Mid- and long-term outcomes of endoscopic resection for submucosal esophageal cancer types pT1b-SM1 and pT1b-SM2

2019 ◽  
Vol 07 (06) ◽  
pp. E733-E742 ◽  
Author(s):  
Andres Mora ◽  
Kenro Kawada ◽  
Yasuaki Nakajima ◽  
Takuya Okada ◽  
Yutaka Tokairin ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Endoscopic Resection ◽  
Survival Rates ◽  
Early Esophageal Cancer ◽  
En Bloc ◽  
Term Survival ◽  
Long Term Survival ◽  
Submucosal Tumors ◽  
Submucosal Cancer

Abstract Background and study aims Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) are promising therapeutic options for early esophageal cancer (EC). The factors that can affect mid- and long-term survival in patients with submucosal EC (SM1 and SM2) have not been described in the literature. We aim to describe clinicopathological outcomes and factors that can affect the mid- and long-term survival in patients with resected submucosal tumors. Patients and methods We performed a retrospective analysis of patients who underwent endoscopic resection (ER) for submucosal tumors over a 20-year period. The final study population included 119 cases with 137 lesions. Information was collected according to the Japanese Classification of Esophageal Cancer 11-edition and factors affecting survival for 2 and 5 years after ER were analyzed. Results EMR was performed in 99 cases (72.3 %), ESD in 38 cases (27.7 %). There were no significant complications. Two- and 5-year survival rates were 91 % and 82 %, respectively. Mean age was 67.22 years (± 9.49 years), mortality caused by EC occurred in 13 cases (11 %). Factors that had a significant impact on long-term survival were age > 65 years (P = 0.0026), number of resected specimens (P = 0.0031), presence of another progressive disease (not EC) (P ≤ 0.001), recurrence (P = 0.0002), and relation between histopathological positive vertical margin and recurrence (P = 0.0112). Conclusions ER is viable treatment for esophageal submucosal cancer, selection between ESD/EMR can depend on tumor size and patient condition, and en bloc ER is the recommended technique for submucosal tumors. Long-term survival factors were identified.

Prognostic factors for medium- and long-term survival of esophageal cancer patients in the Netherlands

2013 ◽  
Vol 109 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Pauline Bus ◽  
Valery E. Lemmens ◽  
Martijn G. van Oijen ◽  
Geert-Jan Creemers ◽  
Grard A. Nieuwenhuijzen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
The Netherlands ◽  
Cancer Patients ◽  
Term Survival ◽  
Long Term Survival

Esophageal Cancer Associated with Multiple Primary Cancers: Surgical Approaches and Long-term Survival

2013 ◽  
Vol 20 (13) ◽  
pp. 4260-4266 ◽  
Author(s):  
Geun Dong Lee ◽  
Yong-Hee Kim ◽  
Joon Bum Kim ◽  
Se Hoon Choi ◽  
Hyeong Ryul Kim ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Surgical Approaches ◽  
Multiple Primary Cancers ◽  
Term Survival ◽  
Long Term Survival ◽  
Multiple Primary

697 ESOPHAGECTOMY ANASTOMOTIC LEAKS DECREASE LONG TERM SURVIVAL AFTER SURGERY FOR ESOPHAGEAL CANCER: MOVING FROM RESCUE TO PREVENTION.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Catherine Cheang ◽  
Pradeep Patil
Keyword(s):  
Esophageal Cancer ◽  
Survival Rates ◽  
Standard Of Care ◽  
Innovative Technology ◽  
Anastomotic Leaks ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
The Difference

Abstract   Multimodal therapy including esophagectomy is the standard of care for esophageal cancer with a view to achieve long-term survival. Leaks from esophageal anastomoses are associated with major short-term morbidity and mortality. The aim of this study was to analyse our anastomotic leaks following esophagectomy for cancer, their effect on short-term mortality and any effect on long term survival. Methods All patients undergoing esophagectomy for esophageal cancer over 10 years from 2011 to 2020 in our centre were selected for this study from a prospectively maintained database. Patients with leaks were identified by reviewing their case records, electronic records, endoscopy and radiological results. All leaks including non-clinical radiological leaks were included in the study. Overall survival was calculated from date of surgery to death or otherwise censored. Statistical analysis was carried out using SPSS. Results 104 consecutive patients were identified of whom 10 patients (9.6%) had anastomotic leaks. 8 of these patients (80%) were rescued and were well enough to be discharged home. The median survival of patients with leaks was 11.6 months compared to 52.9 months for patients without leaks. The 3-year survival was 30% in patients with leaks compared to 59.9% (p = 0.23, Fisher’s exact) in patients without leaks. The Kaplan Meier survival analysis curves are shown here and the difference in survival was very close to being statistically significant with p = 0.089 (Log Rank) and p = 0.056 (Breslow). Conclusion Esophageal anastomotic leak rates are still exceedingly high at 10%. The rescue rate of 80% is significantly better compared to previous decades. Despite the high rescue rate, these patients have extremely poor long-term survival rates. The future should aim for innovative technology and strategies to eliminate esophageal anastomotic leaks for optimal short- and long-term outcomes.

Long-term survival analysis of atypical meningiomas: survival rates, prognostic factors, operative and radiotherapy treatment

2014 ◽  
Vol 156 (8) ◽  
pp. 1475-1481 ◽  
Author(s):  
Salah Hammouche ◽  
Simon Clark ◽  
Alex Hie Lin Wong ◽  
Paul Eldridge ◽  
Jibril Osman Farah
Keyword(s):  
Survival Analysis ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Term Survival ◽  
Long Term Survival ◽  
Atypical Meningiomas ◽  
Radiotherapy Treatment

scholarly journals LYMPHOPARIETAL INDEX IN ESOPHAGEAL CANCER IS STRONGER THAN TNM STAGING IN LONG-TERM SURVIVAL PROGNOSIS IN A LATIN-AMERICAN COUNTRY

2020 ◽  
Vol 33 (3) ◽  
Author(s):  
Manuel FIGUEROA-GIRALT ◽  
Catalina VALENZUELA ◽  
Andrés TORREALBA ◽  
Attila CSENDES ◽  
Italo BRAGHETTO ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Latin American ◽  
Tnm Stage ◽  
Survival Prognosis ◽  
Term Survival ◽  
Long Term Survival ◽  
N Classification ◽  
Anastomotic Fistula

ABSTRACT Background: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. Aim: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal index (N+/T). Method: Prospective study of the Universidad de Chile Clinical Hospital, between January 2004 and December 2013. Included all esophageal cancer surgeries with curative intent and cervical anastomosis. Exclusion criteria included: stage 4 cancers, R1 resections, palliative procedures and emergency surgeries. Results: Fifty-eight patients were included, 62.1% were men, the average age was 63.3 years. A total of 48.3% were squamous, 88% were advanced cancers, the average lymph node harvest was 17.1. Post-operative surgical morbidity was 75%, with a 17.2% of reoperations and 3.4% of mortality. The average overall survival was 41.3 months, the 3-year survival was 31%. Multivariate analysis of the prognostic factors showed that significant variables were anterior mediastinal ascent (p=0.01, OR: 6.7 [1.43-31.6]), anastomotic fistula (p=0.03, OR: 0.21 [0.05-0.87]), N classification (p=0.02, OR: 3.8 [1.16-12.73]), TNM stage (p=0.04, OR: 2.8 [1.01-9.26]), and lymphoparietal index (p=0.04, RR: 3.9 [1.01-15.17]. The ROC curves of lymphoparietal index, N classification and TNM stage have areas under the curve of 0.71, 0.63 and 0.64 respectively, with significant statistical difference (p=0.01). Conclusion: The independent prognostic factors of long-term survival in esophageal cancer are anterior mediastinal ascent, anastomotic fistula, N classification, TNM stage and lymphoparietal index. In esophageal cancer the new lymphoparietal index is stronger than TNM stage in long-term survival prognosis.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

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