Changes in oncological outcomes: comparison of the conventional and minimally invasive esophagectomy, a single institution experience
Autor: | Aamir Ali Syed, Ali Raza Khan, Muhammad Ijaz Ashraf, Anam Muzaffar, Shahid Khatak, Misbah Khan |
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Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Kaplan-Meier Estimate Adenocarcinoma Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Statistical significance Invasive esophagectomy medicine Humans Minimally Invasive Surgical Procedures Pakistan Registries Single institution Retrospective Studies business.industry Medical record Retrospective cohort study Middle Aged Esophageal cancer medicine.disease Surgery Esophagectomy Survival Rate Treatment Outcome 030220 oncology & carcinogenesis Resection margin Female 030211 gastroenterology & hepatology business Follow-Up Studies |
Zdroj: | Updates in Surgery. 68:343-349 |
ISSN: | 2038-3312 2038-131X |
Popis: | Minimally invasive esophagectomy is becoming the routine procedure for resectable esophageal cancer. The aim of this retrospective study is to analyze the oncologic adequacy of these two procedures at our Centre. Out of 1252 registered esophageal cancer patients at our institute from 2006 to 2015, 206 patients who underwent a surgical resection with curative intent and a complete medical record were retrospectively evaluated thru hospital medical record system (HIS). Patients were allocated into the conventional open OE, and minimally invasive MIE and Hybrid esophagectomy groups. Primary outcomes are tumor recurrence and disease-free survival over a minimum follow-up of 1 year along with assessment of adequacy of pathological specimen in terms of lymph nodes harvested and clear longitudinal 1 cm and circumferential (≥1 mm) resection margins for patients with post-neo-adjuvant residual disease. Secondary endpoint is to look for trends in the adequacy of oncologic clearance in each group over the study period. Overall, there was no statistically significant difference (p 0.05) between groups (OE vs. MIE vs. Hybrid) for median number of lymph nodes retrieved (13 vs.14 vs.15), resection margin positive disease (55.8 vs. 35.7 vs. 44 % of patients with any residual disease N = 103,50 %), or tumor recurrence (45.2 vs. 37.3 vs. 25 %). Disease-free survival over a mean follow-up of 2.3 years was higher in the conventional group (13.8 months vs. 9.7MIE and 11.8hybrid) without any statistical significance. Learning curve for MIE to achieve a comparable mean lymph nodes harvest to OE was 1 year, while pathological complete resection stayed persistently better with minimally invasive approach. Minimally invasive esophagectomy is found to be oncologically adequate and gives results matching their conventional analogue with an increasing experience. |
Databáze: | OpenAIRE |
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