Salvage surgery for esophageal cancer: how ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Salvage surgery for esophageal cancer: how to improve outcomes?
Auteur(s) :
Cohen, Charlotte [Auteur]
Tessier, Williams [Auteur]
Hôpital Claude Huriez [Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Gronnier, Caroline [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Renaud, Florence [Auteur]
Service de pathologie [CHU Lille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Pasquer, Arnaud [Auteur]
Thereaux, Jeremie [Auteur]
Gagniere, Johan [Auteur]
Meunier, Bernard [Auteur]
Collet, Denis [Auteur]
Piessen, Guillaume [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Mariette, Christophe [Auteur]
Site de Recherche Intégrée en Cancérologie [SIRIC-ONCOLille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Tessier, Williams [Auteur]
Hôpital Claude Huriez [Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Gronnier, Caroline [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Renaud, Florence [Auteur]

Service de pathologie [CHU Lille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Pasquer, Arnaud [Auteur]
Thereaux, Jeremie [Auteur]
Gagniere, Johan [Auteur]
Meunier, Bernard [Auteur]
Collet, Denis [Auteur]
Piessen, Guillaume [Auteur]

Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Mariette, Christophe [Auteur]
Site de Recherche Intégrée en Cancérologie [SIRIC-ONCOLille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Hôpital Claude Huriez [Lille]
Titre de la revue :
Annals of Surgical Oncology
Nom court de la revue :
Ann. Surg. Oncol.
Numéro :
25
Pagination :
1277–1286
Date de publication :
2018-02-07
ISSN :
1534-4681
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
BACKGROUND: Locoregional recurrence rates after definitive chemoradiotherapy (dCRT) for locally advanced esophageal cancer (EC) are high. Salvage surgery (SALV) is considered the best treatment option in case of persistent ...
Lire la suite >BACKGROUND: Locoregional recurrence rates after definitive chemoradiotherapy (dCRT) for locally advanced esophageal cancer (EC) are high. Salvage surgery (SALV) is considered the best treatment option in case of persistent or recurrent disease for operable patients, but SALV has been associated with increased morbidity and mortality. The aim of this study is to identify factors linked to outcomes after SALV to better select candidates and to optimize perioperative care. METHODS: We retrospectively analyzed data from 308 consecutive SALV patients from a large multicenter European cohort. Univariate and multivariate analyses were performed to identify factors associated with in-hospital postoperative morbidity, anastomotic leakage (AL), and overall survival (OS). RESULTS: The in-hospital postoperative mortality and morbidity rates were 8.4 and 34.7%, respectively. Squamous cell histology (p = 0.040) and radiation dose ≥ 55 Gy (p = 0.047) were independently associated with major morbidity. The AL rate was 12.7%, and cervical anastomosis was independently associated with AL (p = 0.002). OS at 5 years was 34.0%. Radiation dose ≥ 55 Gy (p = 0.003), occurrence of postoperative complications (p = 0.006), ypTNM stage 3 (p = 0.019), and positive surgical margins (p < 0.001) were linked to poor prognosis. CONCLUSIONS: SALV is a valuable option for patients with persistent or recurrent disease after dCRT and offers long-term survival. Factors such as radiation dose and anastomosis location identified here will help to optimize outcomes after SALV, which may be considered a standard treatment in the EC therapeutic armamentarium.Lire moins >
Lire la suite >BACKGROUND: Locoregional recurrence rates after definitive chemoradiotherapy (dCRT) for locally advanced esophageal cancer (EC) are high. Salvage surgery (SALV) is considered the best treatment option in case of persistent or recurrent disease for operable patients, but SALV has been associated with increased morbidity and mortality. The aim of this study is to identify factors linked to outcomes after SALV to better select candidates and to optimize perioperative care. METHODS: We retrospectively analyzed data from 308 consecutive SALV patients from a large multicenter European cohort. Univariate and multivariate analyses were performed to identify factors associated with in-hospital postoperative morbidity, anastomotic leakage (AL), and overall survival (OS). RESULTS: The in-hospital postoperative mortality and morbidity rates were 8.4 and 34.7%, respectively. Squamous cell histology (p = 0.040) and radiation dose ≥ 55 Gy (p = 0.047) were independently associated with major morbidity. The AL rate was 12.7%, and cervical anastomosis was independently associated with AL (p = 0.002). OS at 5 years was 34.0%. Radiation dose ≥ 55 Gy (p = 0.003), occurrence of postoperative complications (p = 0.006), ypTNM stage 3 (p = 0.019), and positive surgical margins (p < 0.001) were linked to poor prognosis. CONCLUSIONS: SALV is a valuable option for patients with persistent or recurrent disease after dCRT and offers long-term survival. Factors such as radiation dose and anastomosis location identified here will help to optimize outcomes after SALV, which may be considered a standard treatment in the EC therapeutic armamentarium.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Collections :
Date de dépôt :
2019-12-09T16:50:43Z
2025-03-06T07:24:14Z
2025-03-06T07:24:14Z