En bloc vs transhiatal esophagectorny for stage T3 N1 adenocarcinorna of the distal esophagus
(2004) In Archives of Surgery 139(6). p.627-631- Abstract
- Hypothesis: En bloc esophagectomy (EBE) provides improved survival over transhiatal esophagectomy (THE) in patients with similarly sized transmural tumors (T3) and lymph node metastases (N1). Design: A retrospective case-control study of 2 methods of esophageal resection for cancer. Setting: University hospital (tertiary referral center for esophageal disease). Patients: There were 49 patients (27 who underwent EBE and 22 who underwent THE) With similar T3 N1 disease and the following matched criteria: tumors of similar size and location, more than 20 lymph nodes in the surgical specimen, R0 resection, no previous chemotherapy or radiation therapy, and follow-up until death or for a minimum of 5 years. Main Outcome Measure: Survival... (More)
- Hypothesis: En bloc esophagectomy (EBE) provides improved survival over transhiatal esophagectomy (THE) in patients with similarly sized transmural tumors (T3) and lymph node metastases (N1). Design: A retrospective case-control study of 2 methods of esophageal resection for cancer. Setting: University hospital (tertiary referral center for esophageal disease). Patients: There were 49 patients (27 who underwent EBE and 22 who underwent THE) With similar T3 N1 disease and the following matched criteria: tumors of similar size and location, more than 20 lymph nodes in the surgical specimen, R0 resection, no previous chemotherapy or radiation therapy, and follow-up until death or for a minimum of 5 years. Main Outcome Measure: Survival adjusted for differences in demographic and patient characteristics. Results: The number of nodes harvested was greatest after EBE vs THE (median, 52 vs 29 [range, 21-85 vs 20-60]; P<.001). The median number of involved nodes was similar after EBE vs THE (median, 5 vs 7 [range, 1-19 vs 1-16]). The only 2 independent factors that affected survival. in a Cox analysis were the number of involved lymph nodes (P=.01) and the type of resection (P=.03). Patients who underwent EBE had a survival benefit over those who underwent THE (P=.01). The survival benefit of EBE was seen only in patients with fewer than 9 involved lymph nodes (P<.001). Conclusion: En bloc esophagectomy confers a better survival than THE in patients with T3 N1 disease and fewer than 9 lymph node metastases. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/275726
- author
- Johansson, Jan LU ; DeMeester, TR ; Hagen, JA ; DeMeester, SR ; Peters, JH ; Öberg, Stefan LU and Bremner, CG
- organization
- publishing date
- 2004
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Archives of Surgery
- volume
- 139
- issue
- 6
- pages
- 627 - 631
- publisher
- American Medical Association
- external identifiers
-
- pmid:15197089
- wos:000221966400017
- scopus:2642576806
- ISSN
- 0004-0010
- language
- English
- LU publication?
- yes
- id
- bdbf4fe6-ee0f-45b5-8f7a-d4af5cfe118e (old id 275726)
- alternative location
- http://archsurg.ama-assn.org/cgi/content/abstract/139/6/627
- date added to LUP
- 2016-04-01 15:33:06
- date last changed
- 2022-03-07 00:14:12
@article{bdbf4fe6-ee0f-45b5-8f7a-d4af5cfe118e, abstract = {{Hypothesis: En bloc esophagectomy (EBE) provides improved survival over transhiatal esophagectomy (THE) in patients with similarly sized transmural tumors (T3) and lymph node metastases (N1). Design: A retrospective case-control study of 2 methods of esophageal resection for cancer. Setting: University hospital (tertiary referral center for esophageal disease). Patients: There were 49 patients (27 who underwent EBE and 22 who underwent THE) With similar T3 N1 disease and the following matched criteria: tumors of similar size and location, more than 20 lymph nodes in the surgical specimen, R0 resection, no previous chemotherapy or radiation therapy, and follow-up until death or for a minimum of 5 years. Main Outcome Measure: Survival adjusted for differences in demographic and patient characteristics. Results: The number of nodes harvested was greatest after EBE vs THE (median, 52 vs 29 [range, 21-85 vs 20-60]; P<.001). The median number of involved nodes was similar after EBE vs THE (median, 5 vs 7 [range, 1-19 vs 1-16]). The only 2 independent factors that affected survival. in a Cox analysis were the number of involved lymph nodes (P=.01) and the type of resection (P=.03). Patients who underwent EBE had a survival benefit over those who underwent THE (P=.01). The survival benefit of EBE was seen only in patients with fewer than 9 involved lymph nodes (P<.001). Conclusion: En bloc esophagectomy confers a better survival than THE in patients with T3 N1 disease and fewer than 9 lymph node metastases.}}, author = {{Johansson, Jan and DeMeester, TR and Hagen, JA and DeMeester, SR and Peters, JH and Öberg, Stefan and Bremner, CG}}, issn = {{0004-0010}}, language = {{eng}}, number = {{6}}, pages = {{627--631}}, publisher = {{American Medical Association}}, series = {{Archives of Surgery}}, title = {{En bloc vs transhiatal esophagectorny for stage T3 N1 adenocarcinorna of the distal esophagus}}, url = {{http://archsurg.ama-assn.org/cgi/content/abstract/139/6/627}}, volume = {{139}}, year = {{2004}}, }