Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer

Kataoka, Kozo; Takeuchi, Hiroya; Mizusawa, Junki; Igaki, Hiroyasu; Ozawa, Soji; T, Abe; Nakamura, Kenichi; Kato, Ken; Ando, Nobutoshi; Kitagawa, Yuko

doi:10.1097/sla.0000000000001828

Cited by 190 publications

(148 citation statements)

References 27 publications

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“…This finding may highlight the utility of NCCRP1 for stratifying patients at risk of adverse prognosis independent of the TNM staging system. Since findings of the JCOG9907 phase III study comparing the survival benefit of pre-or postoperative cisplatin plus fluorouracil in clinical stage II/III ESCC demonstrated the superiority of neoadjuvant chemotherapy, neoadjuvant cisplatin plus fluorouracil followed by esophagectomy has been the standard treatment for patients with ESCC in Japan (19,20). In this study, we found that the prognostic impact of NCCRP1 expression was similar between patients who received neoadjuvant chemotherapy and those who did not.…”

Section: Discussionsupporting

confidence: 55%

“…Patients were questioned to determine their levels of alcohol consumption, and excessive alcohol consumption was defined as >210 g/week for ≥3 years (18). Since 2006, neoadjuvant chemotherapy (fluorouracil combined with platinum-based drugs) was administered to patients with clinical stage II/III ESCC unless contraindicated by the patient's condition or patient refusal (19,20). Postoperative follow-up examinations included physical examination, measurement of serum tumor markers every 3 months, and enhanced computed tomography of the chest and abdominal cavity every 6 months.…”

Section: Methodsmentioning

confidence: 99%

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Identification of NCCRP1 as an epigenetically regulated tumor suppressor and biomarker for malignant phenotypes of squamous cell carcinoma of the esophagus

et al. 2017

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Abstract. The poor prognosis and increasing incidence of esophageal squamous cell carcinoma (ESCC) highlight the need for identification of novel ESCC-associated molecular events to improve the diagnosis, and treatment of this disease. Non-specific cytotoxic cell receptor protein 1 (NCCRP1) was reported to be abundantly expressed in human squamous epithelium and to be involved in cell proliferation; however, the role of NCCRP1 in ESCC remains unclear. To elucidate the oncological roles of NCCRP1 in ESCC, NCCRP1 expression, DNA methylation, and copy numbers were analyzed in ESCC cell lines. Nine ESCC cell lines demonstrated different NCCRP1 mRNA expression levels and all exhibited hypermethylation of the NCCRP1 promoter, but no copy number loss. Additionally, NCCRP1 expression was determined in 213 surgically resected esophageal tissue samples. NCCRP1 mRNA expression levels were reduced in ESCC tissues compared with corresponding non-cancerous adjacent tissues in 204 (95.8%) patients. Patients in the low NCCRP1 expression group tended to have a higher recurrence rate and a shorter overall survival time compared with those in the high NCCRP1 expression group. Additionally, multivariate analysis revealed that low NCCRP1 expression was an independent prognostic factor (hazard ratio, 1.75; 95% confidence interval, 1.08-2.87; P= 0.022). The findings of the current study indicate that NCCRP1 acts as a putative tumor suppressor that is inactivated through promoter hypermethylation, and serves as a promising biomarker to predict postoperative prognosis in ESCC.

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Section: Discussionsupporting

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Identification of NCCRP1 as an epigenetically regulated tumor suppressor and biomarker for malignant phenotypes of squamous cell carcinoma of the esophagus

et al. 2017

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“…Evaluation of variables associated with disease-specific survival using the Kaplan-Meier method with the log-rank test. Postoperative pneumonia after thoraco-abdominal esophagectomy has been reported to be associated with a poor prognosis (15,16). Markar et al reported an association between severe anastomotic leakage and a poor prognosis from 2,944 surgically treated esophageal cancer patients (17).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of abdominal esophageal cancer patients who were treated with esophagectomy

Kitagawa¹,

Namikawa²,

Iwabu³

et al. 2017

mol clin onc

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Abstract. The aim of the present study was to elucidate the characteristics and outcomes of abdominal esophageal cancer patients who were treated with esophagectomy. The records of 210 esophagectomy patients were retrospectively reviewed and the differences in postoperative outcomes and disease-specific survival between squamous cell carcinoma and adenocarcinoma were evaluated. Of the 20 abdominal esophageal cancer patients, 11 had squamous cell carcinoma, 8 had adenocarcinoma and 1 had adenosquamous cell carcinoma. The body mass index and serum albumin levels were significantly lower in the squamous cell carcinoma patients compared with those in the adenocarcinoma patients, and abdominal lymph node metastasis was significantly more frequent in the adenocarcinoma patients. Early recurrence occurred in 5 patients who had postoperative surgical site infection, microscopic residual cancer, and mediastinal lymph node metastasis. A Kaplan-Meier curve indicated a significantly shorter survival time in patients who underwent surgery with a thoraco-abdominal approach, who had postoperative complications, and who had microscopic residual cancer. This study demonstrated the significance of R0 resection and prevention of postoperative complications in improving the prognosis of patients with abdominal esophageal cancer.

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“…Therefore, a totally transmediastinal procedure, if it could be applied safely for esophageal cancer surgery, would be an ideal approach to minimize surgical invasiveness and reduce pneumonia after surgery. Recent studies indicated that pneumonia after esophagectomy may have a negative impact on overall survival, which strongly suggests that the transmediastinal approach might reduce morbidity and prolong survival.…”

Section: Benefits and Limitations Of The Transmediastinal Approachmentioning

confidence: 99%

“…Transthoracic esophagectomy (TTE) has been the standard procedure for ESCC because it allows for extensive mediastinal lymphadenectomy . However, TTE is highly invasive, especially for elderly or comorbid patients, who represent a major population for radical surgery, and it is associated with high morbidity, especially pulmonary complications . Thoracoscopic TTE is widely accepted as a minimally invasive surgery for esophageal cancer, and in a recent randomized control trial, it was reported to have equivalent curability to and less risk for postoperative pneumonia than open surgery …”

Section: Introductionmentioning

confidence: 99%

Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

Fujiwara

Shiozaki

Konishi

et al. 2019

Asian J Endoscop Surgery

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Esophageal squamous cell carcinoma (ESCC), the most common histology of esophageal cancer in Japan and Asia, shows extensive mediastinal spread from an early stage. Therefore, transthoracic esophagectomy with extensive mediastinal lymphadenectomy, including in the upper mediastinum along the recurrent laryngeal nerves, is the gold standard of radical surgery for ESCC. Minimally invasive thoracoscopic esophagectomy has now become a standard option for ESCC. However, transhiatal esophagectomy is regarded as less invasive because it avoids thoracotomy. Yet, it is also considered less curative because it offers a limited surgical view and insufficient mediastinal lymphadenectomy even when conventional specialized mediastinoscopy is used. Recent clinical studies on radical esophagectomy without thoracotomy for ESCC have been reported from Japan. The introduction of novel minimally invasive techniques for the transcervical or transhiatal approach, such as single‐port or robotic surgical devices, have enabled transmediastinal radical esophagectomy for ESCC. This review focuses on the transmediastinal approach for esophageal cancer surgery, which employs minimally invasive techniques to reduce morbidity, and its application to radical surgery for ESCC.

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Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer

Abstract: These results indicate that postoperative infectious complications may worsen patient prognosis after esophagectomy. Performing esophagectomy without postoperative complications, especially pneumonia, may be beneficial for improving survival outcomes.

Cited by 190 publications

References 27 publications

Identification of NCCRP1 as an epigenetically regulated tumor suppressor and biomarker for malignant phenotypes of squamous cell carcinoma of the esophagus

Identification of NCCRP1 as an epigenetically regulated tumor suppressor and biomarker for malignant phenotypes of squamous cell carcinoma of the esophagus

Outcomes of abdominal esophageal cancer patients who were treated with esophagectomy

Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

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