Extended Transthoracic Resection Compared With Limited Transhiatal Resection for Adenocarcinoma of the Mid/Distal Esophagus

Omloo, Jikke M.T.; Lagarde, Sjoerd M.; Hulscher, Jan B F; Reitsma, Johannes B.; Fockens, Paul; Dekken, Herman van; Kate, Fiebo J.W. ten; Obertop, H.; Tilanus, Hugo W.; Lanschot, J. Jan B. van

doi:10.1097/sla.0b013e31815c4037

Cited by 655 publications

(436 citation statements)

References 18 publications

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“…Difficulties in surgical management and an unfavorable prognosis with 5-year survival rates of 30-50 % make this disease a malignancy of great universal concern [4,5,[10][11][12]. The subclassification of GEJ carcinoma provides a useful tool for the selection of the appropriate surgical procedure [4].…”

Section: Introductionmentioning

confidence: 99%

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

et al. 2012

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Background It remains uncertain whether radical lymphadenectomy combined with total gastrectomy actually contributes to long-term survival for Siewert type II adenocarcinoma of the cardia. We identified the pattern of abdominal nodal spread in advanced type II adenocarcinoma and defined the optimal extent of abdominal lymphadenectomy. Methods Eighty-six patients undergoing R0 total gastrectomy for advanced type II adenocarcinoma were identified from the gastric cancer database of 4,884 patients. Prognostic factors were investigated by multivariate analysis. The therapeutic value of lymph node dissection for each station was estimated by multiplying the incidence of were considered not beneficial to dissect, whereas there were substantial therapeutic benefits to dissecting the perigastric nodes of the upper half of the stomach in positions 1-3 and the second-tier nodes in positions 7 and 11. Conclusions Limited lymphadenectomy attained by proximal gastrectomy might suffice as an alternative to extended lymphadenectomy with total gastrectomy for obtaining On behalf

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Section: Introductionmentioning

confidence: 99%

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

et al. 2012

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“…Various studies have been undertaken regarding this aspect of surgery and the two main meta-analysis of these studies failed to show any survival difference [6,7]. The largest trail comparing the two approaches found a trend towards better survival for adenocarcinoma of the lower esophagus with no overall survival advantage between the groups [8].…”

Section: Discussionmentioning

confidence: 99%

Esophagectomy for Cancer of the Esophagus. A Regional Cancer Centre Experience

Vijayakumar

Burrah

Hari

et al. 2013

Indian J Surg Oncol

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Surgery is an important component of treatment for patients with resectable cancer of the mid and lower third of the esophagus. There are many controversies associated with esophagectomy. We share our experience with esophagectomy for cancer of the mid and lower third of the esophagus. Between January 2007 and December 2011, 210 patients with cancer of the esophagus underwent surgery. The patients' pre and intra-operative factors, morbidities and mortality were noted and studied. Transhiatal esophagectomy was done in 175 patients and right transthoracic esophagectomy was done in 35 patients. The most common location of the tumor was lower third and most common histopathology was squamous cell carcinoma. There were 5 in-hospital deaths (2.4 %) and the common morbidities encountered were respiratory (30 %), anastomotic leak (5 %) and anastomotic stricture (15 %). The morbidity was higher in the transthoracic group. Our R0 resection rate was 89 %. Esophagectomy can be accomplished with acceptable morbidity in the management of patients with oesophageal cancer. We attribute the favourable results to the high volume at our centre, surgical expertise, good patient selection and performance of the anastomosis in the neck.

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“…However, the optimal surgical treatment for EGJ carcinoma remains controversial 4, 5, 6, 7, 8, 9, 10, 11, 12, 13. In Western countries, adenocarcinoma (AC) is the major histological type, and the Siewert classification has been adopted 14.…”

Section: Introductionmentioning

confidence: 99%

“…A Dutch trial compared the right thoracic and transhiatal approaches for Siewert tumor types I and II 4. Although the survival rate of patients with Siewert type II tumors was not different between the groups, a subgroup analysis of nodal metastatic patients showed that survival in patients who underwent the transthoracic approach was significantly better than that of patients who underwent the transhiatal approach 4. Squamous cell carcinoma (SCC) of the EGJ is often observed in Asian populations.…”

Section: Introductionmentioning

confidence: 99%

High‐risk group of upper and middle mediastinal lymph node metastasis in patients with esophagogastric junction carcinoma

Yura

Takeuchi

Fukuda

et al. 2018

Annals of Gastroent Surgery

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AimThe aim of the present study was to clarify esophagogastric junction (EGJ) carcinoma patients who are at high risk of upper and middle mediastinal lymph node (MLN) metastasis.MethodsThis was a retrospective study and included 110 consecutive patients with EGJ carcinoma who underwent R0/R1 resection at Keio University Hospital between January 2000 and December 2013.ResultsOf the 110 patients, 18 (16.3%) had MLN metastasis, and the number increased to 23 (20.9%) when recurrence cases were added (adenocarcinoma, N = 11; squamous cell carcinoma, N = 12). Patients whose tumor epicenter was located above the EGJ had a significantly higher incidence of MLN metastasis/recurrence (18/51 [35.3%]) than those whose tumor epicenter was located below the EGJ (5/59 [8.5%]). The MLN metastasis/recurrence rate was particularly high when the distance from the EGJ to the proximal edge of the primary tumor was >3 cm for the upper and middle mediastinum (18.8%). Patients in a selected group (≥T2 and tumor epicenter located above the EGJ or below the EGJ with ≥3 cm esophageal invasion) showed 17.9% and 15.4% upper and middle MLN metastasis/recurrence rates, respectively. Therapeutic value of MLN dissection was relatively high (#105 + 106: 8.9, #110: 12.2).ConclusionsTherapeutic value of MLN dissection to treat EGJ carcinomas was relatively high in patients with MLN metastasis. Our algorithm could select patients at high risk for MLN metastasis.

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Extended Transthoracic Resection Compared With Limited Transhiatal Resection for Adenocarcinoma of the Mid/Distal Esophagus

Cited by 655 publications

References 18 publications

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

Esophagectomy for Cancer of the Esophagus. A Regional Cancer Centre Experience

High‐risk group of upper and middle mediastinal lymph node metastasis in patients with esophagogastric junction carcinoma

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