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En bloc vs transhiatal esophagectorny for stage T3 N1 adenocarcinorna of the distal esophagus

Johansson, Jan LU ; DeMeester, TR; Hagen, JA; DeMeester, SR; Peters, JH; Öberg, Stefan LU and Bremner, CG (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)
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author
organization
publishing date
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
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
2007-10-23 13:27:21
date last changed
2016-04-16 03:05:00
@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&lt;.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&lt;.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},
  volume       = {139},
  year         = {2004},
}