Treatment of esophageal cancer: surgical outcomes of 335 cases operated in a single center

Abstract

Objectives: the surgical approach persists as the main treatment for esophageal cancer. This study compares the patients of the same institution over time at three different times. Methods: this is a retrospective, observational, descriptive study comparing the surgical outcomes obtained by the Division of Surgical Oncology of Erasto Gaertner Hospital. The sample was divided into Period 1 (1987-1997), Period 2 (1998-2003) and Period 3 (2007-2015). Survival rates and disease-free survival were estimated by the Kaplan-Maier method. Survival predictors were identified with Cox regression. ANOVA test was used for comparison between groups. Data were analyzed with SPSS 25.0 and STATA 16, and p<0.05 was considered statistically significant. Results: a total of 335 patients underwent esophagectomy or esophagogastrectomy. When the clinical characteristics of the 3 groups were compared, there was no statistically significant difference. Neoadjuvance was significantly higher in Period 3 (55.4% of patients). We found a histological change in the diagnosis over time, with a significant increase in adenocarcinoma. Morbidity and mortality rates were higher in Period 3. The main complications were pulmonary and anastomotic fistulas. Overall survival in 5 years increased over time, reaching 59.7% in Period 3. Conclusions: better neoadjuvant treatment contributed to increase the global survival of patients, despite greater rate of immediate complications to surgery.

Prevalence of postoperative complications in oncologic gastro-esophageal surgeries: a cross-sectional study

“…Among the main complications found in the literature, anastomotic fistula, hemorrhage, abscess, peritonitis, sepsis, and stroke were the most prevalent 13 – 16 . In comparison, our results not only demonstrated the prevalence of patients with some form of infection but also anastomotic fistulas, hemorrhages, sepsis, and strokes, consistent with other analyzed studies.…”

Drug Delivery Opportunities in Esophageal Cancer: Current Treatments and Future Prospects

“…24 Resection of tumors located in the proximal third of the esophagus is more challenging and morbid due to proximity to the larynx and pharynx, and proximal tumors are therefore typically treated with definitive chemotherapy and radiation. Despite significant advances in surgical techniques including adoption of robotic surgical approaches, 5-year survival remains low, 25 highlighting the need for additional treatment options.…”