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Conference Paper: Outcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience

TitleOutcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience
Authors
Issue Date2017
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
The Society for Surgery of the Alimentary Tract 58th Annual Meeting in Digestive Disease Week (DDW) 2017, Chicago, USA, 6-9 May 2017. In Gastroenterology, 2017, v. 152 n. 5, Suppl. 1, p. S1283, abstract no. Tu1286 How to Cite?
AbstractIntroduction: Minimally invasive esophagectomy and neoadjuvant chemoradiation has gained popularity in the past two decades. The safety and postoperative outcome of videothoracoscopic (VATS) esophagectomy after neoadjuvant chemoradiation (CRT) remains controversial. Methods: From 1994 to 2013, patients with squamous cell cancer of the esophagus who underwent VATS esophagectomy in a single tertiary referral center in Hong Kong were studied. Patients were divided into two groups: (1) VATS esophagectomy and (2) CRT followed by VATS esophagectomy. Patients’ demographics, clinical-pathological data, postoperative outcome and long- term prognosis were compared. Results: A total of 189 patients were studied; 84 in the VATS and 105 in the CRT + VATS group. Patients’ demographics did not differ. CRT +VATS group had longer operating duration (460 vs. 383 mins) as well as thoracoscopy time (180 vs. 156 mins). Postoperatively, VATS group had higher incidence of pneumonia (25% vs. 9.5%, p=0.005), and tracheostomy rate (19% vs. 7.6%, p=0.027). However when only when patients from 2006 onwards were included, pneumonia rates were 20.4% vs. 9.2% (p=0.07) and tracheostomy rates were 7.4% vs. 6.1% (p=0.7). Other complications did not differ. Hospital mortality rate were both at 6%. CRT + VATS group sampled more lymph nodes (median 33.8 (range 1-78) vs. 26 (range 2-72), p=0.006. However again when patients from 2006 were included, the respective numbers were (median 34 (4-78) vs. 29 (2-72), p=0.371). CRT resulted in a 32.4% pCR rate, with consequent lower stage distribution compared to VATS group. Multivariate analysis identified pT-stage, number of involved nodes, and R-category as independent prognostic factors. In the VATS group, only the number of involved nodes and R-category were prognostic. Conclusions: VATS esophagectomy appeared safe after CRT. pT-stage, number of involved lymph nodes and R-category were determinant of long-term prognosis.
DescriptionSSAT Poster Session: Esophageal Diseases III - abstract no. Tu1286
Persistent Identifierhttp://hdl.handle.net/10722/244002
ISSN
2019 Impact Factor: 17.373
2015 SCImago Journal Rankings: 7.170
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, C-
dc.contributor.authorTong, KHD-
dc.contributor.authorChan, SY-
dc.contributor.authorWong, YHI-
dc.contributor.authorLaw, TT-
dc.contributor.authorChan, KKD-
dc.contributor.authorLaw, SYK-
dc.date.accessioned2017-08-25T03:02:22Z-
dc.date.available2017-08-25T03:02:22Z-
dc.date.issued2017-
dc.identifier.citationThe Society for Surgery of the Alimentary Tract 58th Annual Meeting in Digestive Disease Week (DDW) 2017, Chicago, USA, 6-9 May 2017. In Gastroenterology, 2017, v. 152 n. 5, Suppl. 1, p. S1283, abstract no. Tu1286-
dc.identifier.issn0016-5085-
dc.identifier.urihttp://hdl.handle.net/10722/244002-
dc.descriptionSSAT Poster Session: Esophageal Diseases III - abstract no. Tu1286-
dc.description.abstractIntroduction: Minimally invasive esophagectomy and neoadjuvant chemoradiation has gained popularity in the past two decades. The safety and postoperative outcome of videothoracoscopic (VATS) esophagectomy after neoadjuvant chemoradiation (CRT) remains controversial. Methods: From 1994 to 2013, patients with squamous cell cancer of the esophagus who underwent VATS esophagectomy in a single tertiary referral center in Hong Kong were studied. Patients were divided into two groups: (1) VATS esophagectomy and (2) CRT followed by VATS esophagectomy. Patients’ demographics, clinical-pathological data, postoperative outcome and long- term prognosis were compared. Results: A total of 189 patients were studied; 84 in the VATS and 105 in the CRT + VATS group. Patients’ demographics did not differ. CRT +VATS group had longer operating duration (460 vs. 383 mins) as well as thoracoscopy time (180 vs. 156 mins). Postoperatively, VATS group had higher incidence of pneumonia (25% vs. 9.5%, p=0.005), and tracheostomy rate (19% vs. 7.6%, p=0.027). However when only when patients from 2006 onwards were included, pneumonia rates were 20.4% vs. 9.2% (p=0.07) and tracheostomy rates were 7.4% vs. 6.1% (p=0.7). Other complications did not differ. Hospital mortality rate were both at 6%. CRT + VATS group sampled more lymph nodes (median 33.8 (range 1-78) vs. 26 (range 2-72), p=0.006. However again when patients from 2006 were included, the respective numbers were (median 34 (4-78) vs. 29 (2-72), p=0.371). CRT resulted in a 32.4% pCR rate, with consequent lower stage distribution compared to VATS group. Multivariate analysis identified pT-stage, number of involved nodes, and R-category as independent prognostic factors. In the VATS group, only the number of involved nodes and R-category were prognostic. Conclusions: VATS esophagectomy appeared safe after CRT. pT-stage, number of involved lymph nodes and R-category were determinant of long-term prognosis.-
dc.languageeng-
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro-
dc.relation.ispartofGastroenterology-
dc.relation.ispartofDigestive Diseases Week (DDW 2017): Society for Surgery of the Alimentary Tract (SSAT) 58th Annual Meeting-
dc.titleOutcomes of videothoracoscopic esophagectomy with or without neoadjuvant chemoradiation for squamous cell carcinoma of esophagus: A 20-year single-center experience-
dc.typeConference_Paper-
dc.identifier.emailTong, KHD: esodtong@hku.hk-
dc.identifier.emailChan, SY: fsychan@hku.hk-
dc.identifier.emailWong, YHI: iyhwong@hku.hk-
dc.identifier.emailChan, KKD: dkgenes@HKUCC-COM.hku.hk-
dc.identifier.emailLaw, SYK: slaw@hkucc.hku.hk-
dc.identifier.authorityTong, KHD=rp02281-
dc.identifier.authorityWong, YHI=rp02293-
dc.identifier.authorityLaw, SYK=rp00437-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0016-5085(17)34279-8-
dc.identifier.hkuros275028-
dc.identifier.hkuros275170-
dc.identifier.volume152-
dc.identifier.issue5, Suppl. 1-
dc.identifier.spageS1283-
dc.identifier.epageS1283-
dc.identifier.isiWOS:000403140305275-
dc.publisher.placeUnited States-

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