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Conference Paper: Outcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience
Title | Outcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience |
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Authors | |
Issue Date | 2017 |
Publisher | WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro |
Citation | The Society for Surgery of the Alimentary Tract 58th Annual Meeting in Digestive Disease Week (DDW) 2017, Chicago, USA, 6-9 May 2017. In Gastroenterology, 2017, v. 152 n. 5, Suppl. 1, p. S1283, abstract no. Tu1286 How to Cite? |
Abstract | Introduction: Minimally invasive esophagectomy and neoadjuvant chemoradiation has gained popularity in the past two decades. The safety and postoperative outcome of videothoracoscopic (VATS) esophagectomy after neoadjuvant chemoradiation (CRT) remains controversial.
Methods: From 1994 to 2013, patients with squamous cell cancer of the esophagus who underwent VATS esophagectomy in a single tertiary referral center in Hong Kong were studied. Patients were divided into two groups: (1) VATS esophagectomy and (2) CRT followed by VATS esophagectomy. Patients’ demographics, clinical-pathological data, postoperative outcome and long- term prognosis were compared.
Results: A total of 189 patients were studied; 84 in the VATS and 105 in the CRT + VATS group. Patients’ demographics did not differ. CRT +VATS group had longer operating duration (460 vs. 383 mins) as well as thoracoscopy time (180 vs. 156 mins). Postoperatively, VATS group had higher incidence of pneumonia (25% vs. 9.5%, p=0.005), and tracheostomy rate (19% vs. 7.6%, p=0.027). However when only when patients from 2006 onwards were included, pneumonia rates were 20.4% vs. 9.2% (p=0.07) and tracheostomy rates were 7.4% vs. 6.1% (p=0.7). Other complications did not differ. Hospital mortality rate were both at 6%. CRT + VATS group sampled more lymph nodes (median 33.8 (range 1-78) vs. 26 (range 2-72), p=0.006. However again when patients from 2006 were included, the respective numbers were (median 34 (4-78) vs. 29 (2-72), p=0.371). CRT resulted in a 32.4% pCR rate, with consequent lower stage distribution compared to VATS group. Multivariate analysis identified pT-stage, number of involved nodes, and R-category as independent prognostic factors. In the VATS group, only the number of involved nodes and R-category were prognostic.
Conclusions: VATS esophagectomy appeared safe after CRT. pT-stage, number of involved lymph nodes and R-category were determinant of long-term prognosis. |
Description | SSAT Poster Session: Esophageal Diseases III - abstract no. Tu1286 |
Persistent Identifier | http://hdl.handle.net/10722/244002 |
ISSN | 2023 Impact Factor: 25.7 2023 SCImago Journal Rankings: 7.362 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wong, C | - |
dc.contributor.author | Tong, KHD | - |
dc.contributor.author | Chan, SY | - |
dc.contributor.author | Wong, YHI | - |
dc.contributor.author | Law, TT | - |
dc.contributor.author | Chan, KKD | - |
dc.contributor.author | Law, SYK | - |
dc.date.accessioned | 2017-08-25T03:02:22Z | - |
dc.date.available | 2017-08-25T03:02:22Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | The Society for Surgery of the Alimentary Tract 58th Annual Meeting in Digestive Disease Week (DDW) 2017, Chicago, USA, 6-9 May 2017. In Gastroenterology, 2017, v. 152 n. 5, Suppl. 1, p. S1283, abstract no. Tu1286 | - |
dc.identifier.issn | 0016-5085 | - |
dc.identifier.uri | http://hdl.handle.net/10722/244002 | - |
dc.description | SSAT Poster Session: Esophageal Diseases III - abstract no. Tu1286 | - |
dc.description.abstract | Introduction: Minimally invasive esophagectomy and neoadjuvant chemoradiation has gained popularity in the past two decades. The safety and postoperative outcome of videothoracoscopic (VATS) esophagectomy after neoadjuvant chemoradiation (CRT) remains controversial. Methods: From 1994 to 2013, patients with squamous cell cancer of the esophagus who underwent VATS esophagectomy in a single tertiary referral center in Hong Kong were studied. Patients were divided into two groups: (1) VATS esophagectomy and (2) CRT followed by VATS esophagectomy. Patients’ demographics, clinical-pathological data, postoperative outcome and long- term prognosis were compared. Results: A total of 189 patients were studied; 84 in the VATS and 105 in the CRT + VATS group. Patients’ demographics did not differ. CRT +VATS group had longer operating duration (460 vs. 383 mins) as well as thoracoscopy time (180 vs. 156 mins). Postoperatively, VATS group had higher incidence of pneumonia (25% vs. 9.5%, p=0.005), and tracheostomy rate (19% vs. 7.6%, p=0.027). However when only when patients from 2006 onwards were included, pneumonia rates were 20.4% vs. 9.2% (p=0.07) and tracheostomy rates were 7.4% vs. 6.1% (p=0.7). Other complications did not differ. Hospital mortality rate were both at 6%. CRT + VATS group sampled more lymph nodes (median 33.8 (range 1-78) vs. 26 (range 2-72), p=0.006. However again when patients from 2006 were included, the respective numbers were (median 34 (4-78) vs. 29 (2-72), p=0.371). CRT resulted in a 32.4% pCR rate, with consequent lower stage distribution compared to VATS group. Multivariate analysis identified pT-stage, number of involved nodes, and R-category as independent prognostic factors. In the VATS group, only the number of involved nodes and R-category were prognostic. Conclusions: VATS esophagectomy appeared safe after CRT. pT-stage, number of involved lymph nodes and R-category were determinant of long-term prognosis. | - |
dc.language | eng | - |
dc.publisher | WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro | - |
dc.relation.ispartof | Gastroenterology | - |
dc.relation.ispartof | Digestive Diseases Week (DDW 2017): Society for Surgery of the Alimentary Tract (SSAT) 58th Annual Meeting | - |
dc.title | Outcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Tong, KHD: esodtong@hku.hk | - |
dc.identifier.email | Chan, SY: fsychan@hku.hk | - |
dc.identifier.email | Wong, YHI: iyhwong@hku.hk | - |
dc.identifier.email | Chan, KKD: dkgenes@HKUCC-COM.hku.hk | - |
dc.identifier.email | Law, SYK: slaw@hkucc.hku.hk | - |
dc.identifier.authority | Tong, KHD=rp02281 | - |
dc.identifier.authority | Wong, YHI=rp02293 | - |
dc.identifier.authority | Law, SYK=rp00437 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/S0016-5085(17)34279-8 | - |
dc.identifier.hkuros | 275028 | - |
dc.identifier.hkuros | 275170 | - |
dc.identifier.volume | 152 | - |
dc.identifier.issue | 5, Suppl. 1 | - |
dc.identifier.spage | S1283 | - |
dc.identifier.epage | S1283 | - |
dc.identifier.isi | WOS:000403140305275 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0016-5085 | - |