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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
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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
  • 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&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}},
  url          = {{http://archsurg.ama-assn.org/cgi/content/abstract/139/6/627}},
  volume       = {{139}},
  year         = {{2004}},
}