Modern oncological and operative outcomes in oesophageal cancer: the St. James’s hospital experience
| Autor: | Ciara Ryan, Ann-Marie Duff, Sinead King, Noel E Donlon, Maeve A. Lowery, Niall Hughes, Narayanasamy Ravi, Sinead Cuffe, John V. Reynolds, Timothy Nugent, Cathy Enright, Moya Cunninhgam, Jessie A Elliot, Cian Muldoon, Catherine O'Farrell, Claire L. Donohoe, Carmel Wall, J. Moore, Claire Gorry |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Chyle business.industry medicine.medical_treatment Mortality rate Population Cancer Multimodal therapy General Medicine 030204 cardiovascular system & hematology medicine.disease Surgery Cancer registry 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine education Complication business Neoadjuvant therapy |
| Zdroj: | Irish Journal of Medical Science (1971 -). 190:297-305 |
| ISSN: | 1863-4362 0021-1265 |
| Popis: | Oesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center. All patients undergoing surgery or multimodal therapy with curative intent from 2009 to 2018 were studied. All data was recorded prospectively and maintained internally. The period 2009–2013 was compared with 2014–2018 to monitor any change in trends. Four hundred and seventy-five patients (adenocarcinoma 77%, mean age 65; 76% male; 64% neoadjuvant therapy) underwent open surgical resection, 54% via en bloc 2-stage, 19.8% en bloc 3-stage, and 26.5% by a transhiatal approach. New onset atrial fibrillation was the commonest index complication, in 108 (22.7%), 80 (18%) developed suspected pneumonia/respiratory tract infection, 20 (4.2%) an anastomotic leak, and 25 (5.2%) a chyle leak. The 90-day mortality rate was 1.2% and 0.8% at 30 days. The median survival was 77.17 months, with a 5-year survival of 56%. Consistent with registry data on population survival for oesophageal cancer, this study highlights markedly improved survival outcomes in patients treated curatively, reflecting international trends, as well as low mortality rates; however, cardiorespiratory complications remain significant. |
| Databáze: | OpenAIRE |
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