Esophagogastrectomy for carcinoma of the esophagus and cardia: A comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria

Ellis, F. Henry; Heatley, Gerald J.; Krasna, Mark J.; Williamson, Warren A.; Balogh, Károly

doi:10.1016/s0022-5223(97)70256-3

Cited by 183 publications

(77 citation statements)

References 30 publications

(4 reference statements)

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“…However, several authors have criticised the TNM oesophageal staging system, claiming that it poorly stratifies what is a heterogeneous group of patients who have variable prognostic outcomes and undergo different treatment regimens [12][13][14][15][16][17][18][19][20][21][22][23]. The UICC has responded to these recommendations in its seventh edition of TNM staging, released in 2010, by modifying all three aspects of the scoring system.…”

Section: Introductionmentioning

confidence: 99%

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Oesophageal cancer is the seventh most common cause of cancer-related death in the developed world and the incidence of oesophageal adenocarcinoma is now the fastest growing of any gastrointestinal cancer. Lymph node involvement is the single most important prognostic factor in oesophageal cancer. Imaging to determine the extent of lymph node involvement and plan treatment often requires a combination of modalities to avoid under-staging. The seventh edition of the staging system released by the International Union Against Cancer (IUCC) has stratified lymph node involvement according to the number of lymph nodes involved and redefined its groupings for location of metastatic lymph node involvement. This review discusses the prognostic and treatment implications of these modifications and explores micrometastatic lymph node involvement, capsular infiltration and lymph node ratio as possible additions to the staging system.

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Section: Introductionmentioning

confidence: 99%

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…Clinically, in carcinoma of the esophagus with gastric wall invasion, the resected area of the stomach is problematic, because reconstruction is usually performed using a gastric tube. When gastric cancer invades the esophageal wall, it is difficult to choose appropriate surgical methods; namely, whether to take the abdominal or thoracoabdominal approach depends on the distance that the tumor has penetrated beyond the EGJ [8][9][10][11]. In this context, it is necessary to examine the histological features of carcinomas of the esophagus or stomach with invasion beyond the EGJ.…”

Section: Discussionmentioning

confidence: 99%

Histological differences in the invasion of advanced esophageal and gastric carcinoma beyond the esophago-gastric junction

et al. 2000

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tomical features. Some squamous cell carcinomas arising from the lower esophagus invade the gastric wall, and, conversely, some gastric adenocarcinomas invade the esophageal wall. It is important to examine the characteristics of invasion of these tumors, because the surgical approach depends on the extent of tumor invasion [1][2][3][4].The purpose of the present study was to elucidate the histological difference between esophageal squamous cell carcinoma with invasion of the gastric wall and gastric adenocarcinoma with invasion of the esophageal wall. Patients and methodsThirty-six patients with advanced squamous cell carcinoma of the esophagus which had invaded the stomach (esophageal group) and 83 patients with advanced adenocarcinoma of the stomach which had invaded the esophagus (gastric group) were enrolled in this study. We defined advanced carcinomas as tumors deeper than the submucosa. All patients had undergone resection at the First Department of Surgery, Kagoshima University Hospital, between 1980 and 1996. In the 36 patients in the esophageal group, the right thoracoabdominal approach was used in 18, the left thoracoabdominal approach in 13, the transhiatal approach in 4, and the abdominal approach in 1. In the 83 patients in the gastric group, the left thoraco-abdominal approach was used in 53, and the abdominal approach in 30. None of the patients had received radiation therapy or chemotherapy. Early-stage carcinomas were excluded, because the pattern of invasion was confined to the mucosa or submucosa.The resected specimens were treated in a standard fashion throughout the period of the study. To this end, they were fixed on a board after being stretched as far as possible, and the extent of tumor infiltration beyond the Abstract Background. The esophago-gastric junction (EGJ) has several unique anatomical and histological features. We investigated the histological differences between esophageal squamous cell carcinoma with invasion of the gastric wall (esophageal group of patients) and gastric carcinoma with invasion of the esophageal wall (gastric group of patients). Methods. Thirty-six patients in the esophageal group and 83 patients in the gastric group were histologically examined in regard to the mode of invasion. The pattern of tumor invasion beyond the EGJ was classified as continuous or discontinuous. Results. The discontinuous pattern was more frequently seen in the esophageal group than in the gastric group. In the gastric group, however, the distance invaded beyond the EGJ was significantly greater in tumors with the discontinuous pattern than in those with the continuous pattern (P < 0.01). Gastric mucosal invasion at the EGJ was not seen in 36% of the esophageal group, whereas tumor infiltration into the esophageal mucosal layer at the tip beyond the EGJ was found in 60% of the gastric group. The incidence of invasion deeper than the muscularis propria in the gastric and esophageal groups was 18% and 58%, respectively (P < 0.0001). Conclusion. The histological characteristics of eso...

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“…In order for the number of QALYs to be the same whether the natural history model was based on progression through dysplasia, or through the biomarker, the prevalence of the biomarker condition among patients with Barrett's oesophagus must be 33%. No dysplasia to HGD 0.01 37,39,40,42,48 No dysplasia to cancer 0.005 45 LGD to HGD 0.05 37,42,45,47 LGD LGD to no dysplasia 0.63 39,42 HGD to no dysplasia 0.1 42,49 HGD to LGD 0.07 40,42,49 Biomarker + to biomarker ) 0 * Cancer treatment probabilities Resectablity: without surveillance 0.5 5,28,54 Resectablity: with surveillance 0.95 5,28,33 Surgical mortality: without surveillance 0.05 [54][55][56][57] In the best-case scenario, the biomarker-guided oesophagectomy strategy (ME) prevented 76% of cancers, and 93% of cancer deaths compared with OBS. Patients in ME experienced an average 16.707 QALYs at a cost of $2,291 per patient.…”

Section: Natural Historymentioning

confidence: 99%

The cost‐effectiveness of biomarkers for predicting the development of oesophageal adenocarcinoma

Rubenstein

Vakil²,

Inadomi

2005

Aliment Pharmacol Ther

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SUMMARYBackground: The recommended surveillance strategy for oesophageal adenocarcinoma may prevent as few as 50% of cancer deaths. Tissue biomarkers have been proposed to identify high-risk patients. Aim: To determine performance characteristics of an ideal biomarker, or panel of biomarkers, that would make its use more cost-effective than the current surveillance strategy. Methods: We created a Markov model using data from published literature, and performed a cost-utility analysis. The population consisted of 50-year-old Caucasian men with gastro-oesophageal reflux, who were monitored until age 80. We examined strategies of observation only, current practice (dysplasiaguided surveillance), surveillance every 3 months

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Esophagogastrectomy for carcinoma of the esophagus and cardia: A comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria

Cited by 183 publications

References 30 publications

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Histological differences in the invasion of advanced esophageal and gastric carcinoma beyond the esophago-gastric junction

The cost‐effectiveness of biomarkers for predicting the development of oesophageal adenocarcinoma

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