Open Versus Thoracoscopic Esophagectomy in Patients with Esophageal Squamous Cell Carcinoma

Hsu, Po‐Kuei; Huang, Chung‐I; Wu, Yu‐Chung; Chou, Teh-Ying; Hsu, Wen Hu

doi:10.1007/s00268-013-2265-5

Cited by 39 publications

(42 citation statements)

References 42 publications

(60 reference statements)

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“…The development of complications after esophagectomy leads to increased postoperative morbidity and mortality, a prolonged hospital stay, and additional medical costs. A previous study has reported that minimally invasive esophagectomy and avoiding thoracotomy and laparotomy can reduce the rate of respiratory complications [23]. Other authors suggested that perioperative steroid therapy was effective in inhibiting the release of inflammatory mediators and decreasing the rate of postoperative respiratory complications after esophageal cancer surgery [24].…”

Section: Discussionmentioning

confidence: 99%

Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

Yamana

Takeno²,

Shibata³

et al. 2015

Eur Surg Res

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Background: The Geriatric Nutritional Risk Index (GNRI) is a new index recently introduced for predicting the risk of nutrition-related complications. The GNRI has mainly been reported as a simple and accurate tool to assess the nutritional status and prognosis of elderly patients. So far, there have been no reports of the GNRI in patients with gastrointestinal cancer. Our objective was to examine the association between the GNRI and short-term outcomes, especially postoperative complications, in patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction. Materials and Methods: The present study enrolled 122 consecutive patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction. The GNRI at admission to the hospital was calculated as follows: (1.489 × albumin in g/l) + (41.7 × present/ideal body weight). The characteristics and short-term outcomes were compared between two groups: the high (GNRI ≥90) and the low (GNRI <90) GNRI group. The mortality and morbidity rates, especially the rates regarding respiratory complications and anastomotic leakage, were investigated. Results: The mean age of the 122 patients was 63.9 ± 9.1 years (range 43-83). There were no significant differences in either patient or operative characteristics. The low GNRI group had a significantly higher rate of respiratory complications (p = 0.002). A multivariate analysis demonstrated that the GNRI was the only independent significant factor predicting respiratory complications (hazard ratio 3.41, 95% confidence interval 1.19-9.76; p = 0.022). Conclusion: The GNRI is considered to be a clinically useful marker that can be used to assess the nutritional status and predict the development of postoperative respiratory complications in patients with esophageal cancer undergoing esophagectomy and gastric tube reconstruction.

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Section: Discussionmentioning

confidence: 99%

Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

Yamana

Takeno²,

Shibata³

et al. 2015

Eur Surg Res

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“…Consequently, their study demonstrated uncertainty of MIE in treating advanced pT3 esophageal carcinoma. Hsu et al (21) reported that the 3-year DFS rate was better in the MIE group when treating esophageal squamous cell carcinoma (P=0.007). However, after subgroup analysis, there was no significant difference between MIE and open surgery.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive esophagectomy is a safe surgical treatment for locally advanced pathologic T3 esophageal squamous cell carcinoma

Zhang

et al. 2017

J. Thorac. Dis.

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“…Since patients with cervical ESCC would be treated with definitive chemoradiation, only patients with intrathoracic ESCC were included. Preoperative staging workup were previously described [8]. In particular, endoscopic ultrasound (EUS) was an optional procedure, but was required for confirmation of cT1 or cT2 lesions.…”

Section: Methodsmentioning

confidence: 99%

“…The surgical approaches used were minimally invasive esophagectomy (MIE, right-sided video-assisted thoracoscopic surgery [VATS] plus laparoscopic surgery) and hybrid esophagectomy (right-sided VATS plus laparotomy). The details of surgical procedures were previously described [8]. Pathological examination that was conducted according to the 7 th edition AJCC TNM staging system [9].…”

Section: Methodsmentioning

confidence: 99%

Prognostic histological factors in patients with esophageal squamous cell carcinoma after preoperative chemoradiation followed by surgery

Hsu

Chien

et al. 2017

BMC Cancer

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BackgroundPathological response is an important marker for tumor aggressiveness in patients with esophageal squamous cell carcinoma (ESCC) who receive preoperative chemoradiation followed by esophagectomy. We aim to evaluate the prognostic value of histological factors after trimodality treatments.Methods91 patients who received preoperative chemoradiation followed by transthoracic esophagectomy between 2009 and 2014 were included. The pathological examination was reviewed. Overall survival and disease free survival were recorded. Survival analysis was performed using the Cox regression model, and the survival curves were compared by the log-rank test.ResultsSurvival analysis showed lymphovascular invasion (LVI, hazard ratio [HR]: 2.009, p = 0.029), perineural invasion (PNI, HR: 2.226, p = 0.019), ypN stage (HR: 2.041, p = 0.019), extracapsular invasion (ECI, HR: 2.804, p = 0.003), and incomplete resection (HR: 1.897, p = 0.039) as unfavorable prognostic factors affecting overall survival (OS). Moreover, tumor regression grade (TRG, HR: 1.834, p = 0.038), LVI (HR: 1.975, p = 0.038), ECI (HR: 2.836, p = 0.003), and incomplete resection (HR: 2.254, p = 0.007) adversely affected disease-free survival (DFS). Prognostic classification based on poor primary tumor (TRG2/3, LVI(+), and PNI (+)), lymph node (ypN(+) and ECI(+)), and surgical (incomplete resection) factors significantly predicts OS (p = 0.013) and DFS (p = 0.017). However, the use of postoperative adjuvant therapy was not a significant prognostic factor even in medium- and high-risk ESCC patients who underwent trimodality treatments.ConclusionsHistological factors, including primary tumor, lymph node, and surgical factors has high prognostic value for predicting outcomes in ESCC patients receiving preoperative chemoradiation followed by surgery.

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Open Versus Thoracoscopic Esophagectomy in Patients with Esophageal Squamous Cell Carcinoma

Abstract: The perioperative benefit of thoracoscopic esophagectomy included fewer postoperative complications and shorter ICU stays. Mid-term OS and DFS associated with thoracoscopic techniques are at least equivalent to those associated with open procedures.

Cited by 39 publications

References 42 publications

Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

Minimally invasive esophagectomy is a safe surgical treatment for locally advanced pathologic T3 esophageal squamous cell carcinoma

Prognostic histological factors in patients with esophageal squamous cell carcinoma after preoperative chemoradiation followed by surgery

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