scholarly journals Significance of Tumor Length as Prognostic Factor for Esophageal Cancer

2013 ◽  
Vol 98 (3) ◽  
pp. 234-240 ◽  
Author(s):  
Arife Zeybek ◽  
Abdullah Erdoğan ◽  
Kemal Hakan Gülkesen ◽  
Makbule Ergin ◽  
Alpay Sarper ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Specific Treatment ◽  
Disease Free Survival ◽  
Curative Surgery ◽  
Thoracic Esophageal Cancer ◽  
Clinicopathologic Characteristics ◽  
Term Survival ◽  
Tumor Length ◽  
Significant Difference

Abstract Our study indicated the relationship between tumor length and clinicopathologic characteristics as well as long-term survival in esophageal cancer. A total of 116 patients who underwent curative surgery for thoracic esophageal cancer with standard lymphadenectomy in 2 fields between 2000 and 2010 were included in the study. The medical records of these patients were retrospectively reviewed. The patients with tumor length ≥3 cm had a highly significant difference in the involvement of adventitia and lymph node stations. The patients with tumor length ≤3 cm had significantly lower rates of involvement of the adventitia and lymph node stations. Tumor length could have a significant impact on both the overall survival and disease-free survival of patients with resected esophageal carcinomas and may provide additional prognostic value to the current tumor, node, and metastasis staging system before patients receive any cancer-specific treatment.

RA02.01: COMPARISON OF THREE-FIELD VERSUS TWO-FIELD LYMPHADENECTOMY FOR THORACIC MIDDLE AND LOWER ESOPHAGEAL CANCER: POST-OPERATIVE RESULTS OF A RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 19-20
Author(s):  
Bin Li ◽  
Jiaqing Xiang ◽  
Yawei Zhang ◽  
Jie Zhang ◽  
Yihua Sun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Postoperative Complications ◽  
Lymph Nodes ◽  
Conflicts Of Interest ◽  
Tumor Staging ◽  
Operating Time ◽  
Thoracic Esophageal Cancer ◽  
Term Survival

Abstract Background Patients with esophageal cancer can benefit from extended lymphadenectomy. However, the role of 3-field lymphadenectomy is unclear, and the extent of lymphadenectomy for thoracic esophageal cancer is still under discussion. Methods From June 2013 to November 2016, 400 patients with middle and lower thoracic esophageal cancer were randomly assigned to receive 3-field (3FL, n = 200) or the 2-field (2FL, n = 200) lymphadenectomy. The postoperative complications, according to the Clavien-Dindo classification, and lymph node metastasis were compared on the basis of intention-to-treat principle. Results Baseline characteristics were balanced between the 2 arms. There were 187 patients (93.5%) had squamous cell carcinoma in 3FL arm, and 192 (96.0%) in the 2FL arm, P = 0262. According to the pathological reports, T staging in the 2 arms were comparable, however more N3 patients in the 3FL arm (10.5%, 21/200) than that in the 2FL arm (10%, 5/200), P = 0040. Consequently, less TNM staging I patients in the 3FL arm (16.0%, 32/200) than that in the 2FL arm (25.5%, 51/200), P = 0.019. Operating time was significantly longer in the 3FL arm (median, 183 vs. 168 [2FL] minutes, P < 0.001). Six patients in the 3FL arm (3%, 6/200) had reintubation, whereas no reintubation in the 2 FL arm (0%, 0/200), P = 0.030. Other postoperative complications were comparable in the 2 arms. One patient in the 2-field arm died of chyloperitoneum. According to the Clavien-Dindo classification of surgical complications, the distribution of severity were similar between the 2 arms, P = 0.416. More lymph nodes were resected in the 3FL arm (Median, 37 vs. 24 [2FL], P < 0.001). Lymph nodes resected in the mediastinum and upper abdomen were comparable between the 2 arms. 44 patients (22%) in the 3FL arm had positive lymph nodes. Conclusion Compared with 2-field lymphadenectomy, 3-field lymphadenectomy doesn’t increase the surgical risks for patients with thoracic esophageal cancer. 3-field lymphadenectomy can be performed safely, removing unforeseen cervical positive lymph node, and offering more accurate tumor staging. Long-term survival analysis under protocol will clarify the role of 3-field lymphadenectomy for esophageal cancer. Disclosure All authors have declared no conflicts of interest.

Clinical effects of esophagectomy for patients 80 years of age and older with thoracic esophageal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4049-4049
Author(s):  
M. Morita ◽  
K. Nishida ◽  
T. Koga ◽  
A. Egashira ◽  
E. Tokunaga ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Elderly Patients ◽  
Disease Free Survival ◽  
Clinical Effects ◽  
Thoracic Esophageal Cancer ◽  
Operative Morbidity ◽  
Group Iii ◽  
Subtotal Esophagectomy ◽  
Group I ◽  
Significant Difference

4049 Background: Esophageal cancer tends to mainly occur in elderly patients. Although a radical operation is the most effective existing therapy, the associated operative morbidity is still high. As a result, the indications for an esophagectomy in elderly patients (especially for patients over 80 years of age) remain controversial. Methods: A total of 599 patients with thoracic esophageal cancer who underwent an esophagectomy by the transthoracic approach since 1986 were evaluated. They were divided into 3 groups depending on age, namely groups I (<69 y.o., n = 441), II (70–79 y.o., n = 143) and III (≥80 y.o., n = 15). No significant differences were observed in the location of the tumor, histological type or stage. A distal esophagectomy with a left thoracotomy was performed for 40, 46, and 47% of the patients, respectively, while the others underwent a subtotal esophagectomy with a right thoracotomy. In group III, surgery was only done for cases with PS 0 or 1 as well as a normal cardiac and pulmonary function (ejection fraction ≥65 %, vital capacity ≥80 %, FEV 1.0% > 70%). Results: Postoperative complications occurred in 31 % of group I and 39 % of group II patients, and the incidence of pulmonary complication was 9 and 18 %, respectively (P < 0.01). In group III, the operative morbidity and mortality were 27 and 0 %, respectively, and pulmonary complications only occurred in one patient (7%). No significant difference was observed in the disease-free survival (DFS: 50, 46 and 58 % for 3yrs, 44, 40 and 33 % for 5 yrs), while the overall survival rates were worse in the older groups as a result of death due to causes other than recurrence (45, 34 and 34 % for 3yrs and 38, 26 and 9 % for 5 yrs in groups I, II and III, respectively. P < 0.01 group I v.s. II). Conclusions: An esophagectomy is considered to be a viable treatment alternative in patients over 80 years of age without increasing morbidity, when the indications for surgery are strictly determined. Furthermore, the DFS in these patients was similar to that observed in younger patients although the incidence of death due to causes other than cancer was found to be higher. An esophagectomy should therefore be considered as an effective treatment strategy even in elderly patients over 80 years of age. No significant financial relationships to disclose.

scholarly journals Efficacy and Safety of Albumin-Bound Paclitaxel Compared to Docetaxel as Neoadjuvant Chemotherapy for HER2-Negative Breast Cancer

2022 ◽  
Vol 11 ◽  
Author(s):  
Zhi-Dong Lv ◽  
Hong-Ming Song ◽  
Zhao-He Niu ◽  
Gang Nie ◽  
Shuai Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Lymph Node Status ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Paclitaxel Group ◽  
Docetaxel Group

BackgroundNanoparticle albumin-bound paclitaxel (nab-paclitaxel) as neoadjuvant chemotherapy (NAC) for breast cancer remains controversial. We conducted a retrospective study to compare the efficacy and safety of nab-paclitaxel with those of docetaxel as neoadjuvant regimens for HER2-negative breast cancer.MethodsIn this retrospective analysis, a total of 159 HER2-negative breast cancer patients who had undergone operation after NAC were consecutively analyzed from May 2016 to April 2018. Patients were classified into the nab-paclitaxel group (n = 79, nab-paclitaxel 260 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) and the docetaxel group (n = 80, docetaxel 75 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) according to the drug they received for neoadjuvant treatment. The efficacy and adverse events were evaluated in the two groups.ResultsThe pathological complete response (pCR)(ypT0/isN0) rate was significantly higher in the nab-paclitaxel group than in the docetaxel group (36.71% vs 20.00%; P = 0.031). The multivariate analysis revealed that therapeutic drugs, lymph node status, and tumor subtype were the most significant factor influencing treatment outcome. At a median follow-up of 47 months, disease-free survival (DFS) was not significantly different in those assigned to nab-paclitaxel compared with docetaxel (82.28% vs 76.25%; P = 0.331). The incidence of peripheral sensory neuropathy in the nab-paclitaxel group was higher than that in the docetaxel group (60.76% vs 36.25%; P = 0.008), while the incidence of arthralgia was observed more frequently in the docetaxel group (57.50% vs 39.97%; P = 0.047).ConclusionsCompared with docetaxel, nab-paclitaxel achieved a higher pCR rate, especially those patients with triple-negative breast cancer or lymph node negative breast cancer. However, there was no significant difference in DFS between the two groups. This study provides a valuable reference for the management of patients with HER2-negative breast cancer.

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