Retrospective Study Using the Propensity Score to Clarify the Oncologic Feasibility of Thoracoscopic Esophagectomy in Patients with Esophageal Cancer

Takeno, Shinsuke; Takahashi, Yoshiaki; Moroga, Toshihiko; Kawahara, Katsunobu; Yamashita, Yuichi; Ohtaki, Megu

doi:10.1007/s00268-013-2008-7

Cited by 22 publications

(17 citation statements)

References 48 publications

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“…The number of dissected recurrent laryngeal nodes was increased in the thoracoscopic approach group compared with the open thoracotomy group, as described in our previous report [20]. In addition, the feasibility of thoracoscopic esophagectomy in the prognostic analysis was suggested in previous reports, and it seems proper to use both data from open thoracic and thoracoscopic esophagectomy in the prognostic analysis [17,18,19,20]. While tumor location still had no significant prognostic impact by surgical approach group, the UE tended to show a more favorable prognosis in thoracoscopic surgery.…”

Section: Discussionsupporting

confidence: 54%

“…Law et al [7 ]and Li et al [8] reported that the UE showed a less favorable prognosis compared with lower ESCC, because lymph node dissection around the tracheal tree and recurrent laryngeal nerve was difficult, and a more meticulous dissection of bilateral recurrent laryngeal nerve nodes might improve the prognosis. In addition, several recent reports have suggested that thoracoscopic esophagectomy might increase the number of harvested recurrent nerve nodes, and they argued that thoracoscopic esophagectomy provided a magnified field allowing more precise surgical manipulations [16,17,18,19,20]. Furthermore, positive recurrent laryngeal nerve nodes were observed more frequently in the UE group, as mentioned above.…”

Section: Discussionsupporting

confidence: 50%

“…We therefore examined the prognostic impact of tumor location in open thoracotomy and thoracoscopic approach groups. The number of dissected recurrent laryngeal nodes was increased in the thoracoscopic approach group compared with the open thoracotomy group, as described in our previous report [20]. In addition, the feasibility of thoracoscopic esophagectomy in the prognostic analysis was suggested in previous reports, and it seems proper to use both data from open thoracic and thoracoscopic esophagectomy in the prognostic analysis [17,18,19,20].…”

Section: Discussionmentioning

confidence: 64%

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Is the Prognostic Impact of Tumor Location in Patients with<b> </b>Surgically Resected Esophageal Squamous Cell Carcinoma Affected by Surgical Approach?

Takeno

Takahashi²,

Hashimoto³

et al. 2013

Eur Surg Res

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Aim: The aim of the present study was to clarify differences in node metastasis mode and clinical outcomes based on tumor location in patients with esophageal squamous cell carcinoma (ESCC). Patients and Methods: Participants comprised 228 patients with ESCC who underwent radical esophagectomy without preoperative supplement therapies. Lymph nodes were harvested from three fields: the neck, thorax, and abdomen. Patients were divided into three groups depending on tumor location [upper esophagus (UE), middle esophagus, or lower esophagus (LE)] and analyzed clinicopathologically. Results: The LE group showed significantly more progressive ESCC in terms of tumor invasion (p = 0.025), node metastasis (p = 0.0071), and TNM stage (p = 0.0043). The LE group revealed a tendency to metastasize to extrathoracic (especially abdominal) nodes (p = 0.0008). Recurrent laryngeal node metastasis was increased in the UE group (p = 0.016). However, no prognostic differences were detected between groups according to tumor location. Likewise, subgroup analyses by surgical approach (open thoracotomy vs. thoracoscopy) and cancer stage (stage I/II, III, and IV) did not reveal any significant prognostic impact of tumor location. Conclusion: Lymphatic spread varied by tumor location, but no prognostic impact of tumor location could be detected in patients with ESCC in spite of surgical approach or cancer stage.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 64%

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Is the Prognostic Impact of Tumor Location in Patients with<b> </b>Surgically Resected Esophageal Squamous Cell Carcinoma Affected by Surgical Approach?

Takeno

Takahashi²,

Hashimoto³

et al. 2013

Eur Surg Res

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“…The rate of open thoracotomies for the low GNRI group tended to be higher than that for the high GNRI group (46.4 vs. 28.7%; p = 0.108). Takeno et al [27] suggested that the method of open thoracotomy was limited for complete dissection, especially for upper mediastinal dissection. Therefore, it was thought that the number of lymph nodes dissected was significantly different between the high and the low GNRI group.…”

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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“…In many reports, the number of patients and the follow-up periods were insufficient to analyze the survival. However, recent studies, in which the surgical procedures were performed with the patient in a decubitus position at a single institution, have shown 5-year survival rates comparable to those for a historical control and OE [28,[71][72][73]. Yet, no studies have reported the long-term survival after MIE-PP, and the survival outcomes after MIE-PP and MIE-LP have not been compared.…”

Section: Technical Limitations Of Mie-ppmentioning

confidence: 84%

Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review

2015

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Retrospective Study Using the Propensity Score to Clarify the Oncologic Feasibility of Thoracoscopic Esophagectomy in Patients with Esophageal Cancer

Abstract: TSE can contribute to prolonged survival after surgery in patients with esophageal cancer by enabling precise thoracic lymph node dissection based on a magnified surgical field. TSE might have maximum oncologic benefit and minimum invasiveness for patients with esophageal cancer.

Cited by 22 publications

References 48 publications

Is the Prognostic Impact of Tumor Location in Patients with<b> </b>Surgically Resected Esophageal Squamous Cell Carcinoma Affected by Surgical Approach?

Is the Prognostic Impact of Tumor Location in Patients with<b> </b>Surgically Resected Esophageal Squamous Cell Carcinoma Affected by Surgical Approach?

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

Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review

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