The impact of operative approach for oesophageal cancer on outcome: The transhiatal approach may influence circumferential margin involvement

2012 ◽  
Vol 38 (2) ◽  
pp. 157-165 ◽  
Author(s):  
S.A. Suttie ◽  
S. Nanthakumaran ◽  
R. Mofidi ◽  
T. Rapson ◽  
F.J. Gilbert ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Operative Approach ◽  
Circumferential Margin ◽  
Margin Involvement ◽  
Transhiatal Approach ◽  
The Impact

scholarly journals Accuracy of High-Resolution MRI with Lumen Distention in Rectal Cancer Staging and Circumferential Margin Involvement Prediction

2014 ◽  
Vol 15 (1) ◽  
pp. 37 ◽  
Author(s):  
Elsa Iannicelli ◽  
Sara Di Renzo ◽  
Mario Ferri ◽  
Emanuela Pilozzi ◽  
Marco Di Girolamo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Resolution ◽  
Cancer Staging ◽  
Circumferential Margin ◽  
Margin Involvement ◽  
Rectal Cancer Staging ◽  
High Resolution Mri

scholarly journals Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms (VAGAS score): characterisation of alarm symptoms in advanced gastro-oesophageal cancer and its correlation with outcome

ESMO Open ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. e000623
Author(s):  
Hannah Christina Puhr ◽  
Eleonore Pablik ◽  
Anna Sophie Berghoff ◽  
Gerd Jomrich ◽  
Sebastian Friedrich Schoppmann ◽  
...  
Keyword(s):  
Risk Prediction ◽  
Oesophageal Cancer ◽  
Clinical Decision Making ◽  
Stage Iv ◽  
Clinical Decision ◽  
Prediction Score ◽  
Prognostic Information ◽  
Initial Symptoms ◽  
The Impact ◽  
Her2 Positivity

IntroductionThe prognostic value of symptoms at disease presentation of advanced gastro-oesophageal cancer is unknown. Thus, the aim of this study was to characterise these symptoms and correlate them with the outcome, so new prognostic markers can be defined.MethodsWe analysed clinical data including symptoms, therapies and survival of patients with stage IV gastro-oesophageal cancer treated between 2002 and 2018 at the Vienna General Hospital, Austria. Initial symptoms as well as stenosis in endoscopy and HER2 positivity were evaluated in a cross-validation model to ascertain the impact of each variable on patient survival.ResultsIn total, 258 patients were evaluated. Five factors (stenosis in endoscopy, weight loss, HER2 positivity, dyspepsia, ulcer or active bleeding) have proven to be statistically relevant prognostic factors and were given a count of +1 and −1, if applicable. The resulting score ranges between −3 and +2. The survival probability for 180 days with a score of −3/–2, −1, 0, +1 and +2 is 90%, 80%, 73%, 72% and 42%, whereas for 2 years, it is 30%, 30%, 8%, 7% and 3%, respectively. The median overall survival of a score of −3/–2, −1, 0, +1 and +2 was 579 (95% CI 274 to not measurable), 481 (95% CI 358 to 637), 297 (95% CI 240 to 346), 284 (95% CI 205 to 371), 146 (95% CI 120 to 229) days, respectively.ConclusionThe data from this retrospective study indicate that the Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms score provides independent prognostic information that may support clinical decision making at diagnosis of advanced gastro-oesophageal cancer. Our findings should be evaluated in prospective studies.

scholarly journals Meta-analysis of prognostic factors of overall survival in patients undergoing oesophagectomy for oesophageal cancer

2020 ◽  
Vol 33 (11) ◽  
Author(s):  
Sivesh K Kamarajah ◽  
Ella J Marson ◽  
Dengyi Zhou ◽  
Freddie Wyn-Griffiths ◽  
Aaron Lin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Staging System ◽  
Tumor Grade ◽  
Pooled Analysis ◽  
Prognostic Models ◽  
Biological Variables ◽  
The Impact

ABSTRACT Introduction Currently, the American Joint Commission on Cancer (AJCC) staging system is used for prognostication for oesophageal cancer. However, several prognostically important factors have been reported but not incorporated. This meta-analysis aimed to characterize the impact of preoperative, operative, and oncological factors on the prognosis of patients undergoing curative resection for oesophageal cancer. Methods This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus, and Cochrane CENTRAL databases up to 31 December 2018. A meta-analysis was conducted with the use of random-effects modeling to determine pooled univariable hazard ratios (HRs). The study was prospectively registered with the PROSPERO database (Registration: CRD42018157966). Results One-hundred and seventy-one articles including 73,629 patients were assessed quantitatively. Of the 122 factors associated with survival, 39 were significant on pooled analysis. Of these. the strongly associated prognostic factors were ‘pathological’ T stage (HR: 2.07, CI95%: 1.77–2.43, P < 0.001), ‘pathological’ N stage (HR: 2.24, CI95%: 1.95–2.59, P < 0.001), perineural invasion (HR: 1.54, CI95%: 1.36–1.74, P < 0.001), circumferential resection margin (HR: 2.17, CI95%: 1.82–2.59, P < 0.001), poor tumor grade (HR: 1.53, CI95%: 1.34–1.74, P < 0.001), and high neutrophil:lymphocyte ratio (HR: 1.47, CI95%: 1.30–1.66, P < 0.001). Conclusion Several tumor biological variables not included in the AJCC 8th edition classification can impact on overall survival. Incorporation and validation of these factors into prognostic models and next edition of the AJCC system will enable personalized approach to prognostication and treatment.

Prognostic significance of circumferential margin involvement after long-term preoperative chemoradiotherapy and surgery for rectal cancer

2004 ◽  
Vol 11 (S2) ◽  
pp. S111-S111
Author(s):  
P. Luna ◽  
A. Maffuz ◽  
S. Rodriguez ◽  
M. Gutierrez de la Barrera ◽  
I. Alvarado ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Significance ◽  
Preoperative Chemoradiotherapy ◽  
Circumferential Margin ◽  
Margin Involvement

scholarly journals TP9.2.18Are delays to diagnosis and treatment associated with reduced survival in oesophageal cancer?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Matteo Magnoli ◽  
Ellen Murgitroyd ◽  
Peter J Lamb ◽  
Richard JE Skipworth
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Oesophageal Cancer ◽  
Survival Rates ◽  
Tnm Stage ◽  
Diagnosis And Treatment ◽  
Cochrane Library ◽  
Optimal Timing ◽  
Randomised Controlled ◽  
The Impact

Abstract Aims Oesophageal cancer has low survival rates due to diagnosis commonly occurring in advanced stages. We performed a systematic review of delays to diagnosis and treatment in oesophageal cancer, and the impact of delay on clinical outcome. Methods A systematic review of Pubmed, Embase and Cochrane Library was carried out using the following search terms: (esophageal cancer) AND ((time) OR (diagnosis)) AND ((delay) OR (wait)). 821 results in English were retrieved and independently reviewed by two researchers. Studies were included if they were randomised controlled trials (RCT), meta-analyses or observational studies, and assessed delay in relation to at least one clinical outcome or TNM stage at diagnosis. Results 15277 patients across 12 studies were included. 10/12 studies were retrospective, and there were no RCT. Heterogeneity existed amongst the studies in defining delay and outcomes (morbidity = 1/12, mortality = 2/12, disease-free = 2/12 or overall survival = 5/12, TNM stage = 6/12). No studies demonstrated that reduced delay improved clinical outcome. Longer patient delay correlated with presence of malnutrition in one study but did not result in reduced survival. Conclusions Systematic review of published literature did not demonstrate a relationship between diagnosis/treatment delay and patient outcome in oesophageal cancer. Multi-centre prospective studies/RCTs are required to identify the impact of delay and the optimal timing of treatment.

PS01.196: SHORT-TERM AND MEDIUM-TERM OUTCOMES IN PATIENTS OVER 70 DIAGNOSED WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 105-105
Author(s):  
Anantha Madhavan ◽  
Nicola Wyatt ◽  
Charlotte Boreham ◽  
Alexander Phillips ◽  
S Michael Griffin
Keyword(s):  
Oesophageal Cancer ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Major Complication ◽  
Radio Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background Oesophageal cancer incidence has increased over the last decade in the UK, particularly in older patients. Surgery, with or without perioperative chemotherapy, remains the gold standard treatment for patients with potentially curable disease. Currently, 41% of new cases of oesophageal cancer are in patients aged over 70. However, only 10% underwent surgery compared to 25% of those aged under 70. Concerns exist that advanced age may prejudice treatment decisions. The aim of our review is to evaluate the impact of age on outcomes in those undergoing planned curative treatment for oesophageal cancer. Methods A retrospective review of patients undergoing oesophagectomy for carcinoma between 2006 to 2016 at a single institution was performed. Patients were divided into two cohorts based on age at the time of diagnosis; under 70 years (Group A) and over 70 (Group B). Patients underwent a standardised staging protocol and treatment was decided by a multi-disciplinary team. Oesophagectomy was performed using a transthoracic approach with two field lymphadenectomy and perioperative chemo (radio) therapy used in those patients with locally advanced disease who were fit enough. Results There were 555 patients in Group A and 241 in Group B. Adenocarcinoma was the prevalent histological subtype in both cohorts: 76% (423) in Group A and 68% (165) in Group B. Median age at the time of diagnosis was 62 in Group A versus 74 in Group B. In Group A, 12% (18/343) did not receive neo-adjuvant treatment for locally advanced cancer versus 47% (101/212) in Group B (P < 0.001). Median hospital stay was longer in Group B (18 v 15 days P = 0.02). There was no significant difference in hospital mortality (Group A 1% vs Group B 2.4% P = 0.37) and major complication rate (Group A 14% vs Group B 20% P = 0.31). Two-year survival was 66% (adenocarcinoma) and 78% (SCC) in Group A compared to 60% (adenocarcinoma) and 64% (SCC) in Group B. Conclusion These results demonstrate that patients over 70 can be treated successfully with minimal additional risk to morbidity and mortality. However, these patients are more likely to be denied neoadjuvant treatment which may compromise their long-term outcomes. Disclosure All authors have declared no conflicts of interest.

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