Title :

Impact of primary endoscopic resection on oncological outcomes after esophagectomy for cancer: a retrospective propensity score-based cohort study

Author(s) :

Teixeira Farinha, Hugo [Auteur]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne] [CHUV]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Behal, Helene [Auteur]
Service de Biostatistiques [CHRU Lille]
Cailliau, Emeline [Auteur]
Service de Biostatistiques [CHRU Lille]
Pasquer, Arnaud [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Duhamel, Alain [Auteur]
Service de Biostatistiques [CHRU Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Théréaux, Jérémie [Auteur]
Hôpital de la Cavale Blanche - CHRU Brest [CHU - BREST ]
Chalret Du Rieu, Mael [Auteur]
Clinique des cèdres - Ramsay Santé
Lefevre, Jérémie [Auteur]
CHU Saint-Antoine [AP-HP]
Turner, Kathleen [Auteur]
Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes]
Mantziari, Styliani [Auteur]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne] [CHUV]
Collet, Denis [Auteur]
Université de Bordeaux Ségalen [Bordeaux 2]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Piessen, Guillaume [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Gronnier, Caroline [Auteur]
Université de Bordeaux Ségalen [Bordeaux 2]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]

Journal title :

Surgical Endoscopy

Abbreviated title :

Surg Endosc

Volume number :

38

Pages :

5169-5177

Publisher :

Springer Verlag (Germany)

Publication date :

2024-07-22

ISSN :

1432-2218

English keyword(s) :

Endoscopic resection
Esophageal cancer
Esophagectomy
Oncological outcomes

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background: Esophageal cancer posed significant global health challenges, particularly due to poor survival rates, especially in advanced stages. Primary endoscopic resection had emerged as an alternative treatment for ...
Show more >Background: Esophageal cancer posed significant global health challenges, particularly due to poor survival rates, especially in advanced stages. Primary endoscopic resection had emerged as an alternative treatment for early esophageal cancer, aiming to preserve organ function and reduce surgical morbidity. Methods: This retrospective multicenter cohort study included 334 patients with early esophageal cancer (T1a-b, N0) from 30 French-speaking European centers between 2000 and 2010. Patients underwent either primary endoscopic resection followed by esophagectomy (E group, n = 36) or esophagectomy alone (S group, n = 298). Cox proportional hazards models adjusted for TNM stage and propensity score weighting were used to assess the impact of primary endoscopic resection on recurrence-free survival (RFS), overall survival (OS), and postoperative complications. Results: Primary endoscopic resection did not significantly influence RFS (adjusted HR 0.92, 95% CI 0.31 to 2.68, p = 0.88) or OS (adjusted HR 1.06, 95% CI 0.35 to 3.13, p = 0.92) compared to esophagectomy alone. Initial higher thromboembolic complications in the endoscopic resection group were not significant after adjustment (adjusted OR 4.73, 95% CI 0.34 to 64.27, p = 0.24). Conclusions: Primary endoscopic resection followed by esophagectomy for early esophageal cancer did not alter oncological outcomes or overall survival in this retrospective cohort. These findings supported the role of primary endoscopic resection as a safe initial treatment strategy, warranting validation in larger prospective studies. Registration: Our study was registered retrospectively on the Clinicaltrials.com website under the identifier NCT01927016. We acknowledge the importance of prospective registration and regret that this was not done before the commencement of the study.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2024-10-17T21:04:35Z
2024-10-31T15:00:11Z