Abstract
The treatment of esophageal cancer is in constant evolution. Most of the esophageal cancer receive induction chemoradiation therapy. Surgical delay has been studied but the optimal timing ...has not been clarified. Through the years, surgical delay has been modified by surgeons in our institutions, going from an average of 6 weeks delay to an average of 10 weeks delay. It is time to ask if this change has a real positive impact on our patient.
Methods
In this retrospective multi-center study, we combined data from two center in Quebec city that performs oncologic esophagectomy. The surgical delay went from 6 to 10 weeks around 2014. All surgeons changed their practice at that moment. We retrospectively analysed 5 years before and after the change of practice and created two cohorts of patients. Our primary outcome compared complete pathologic response rate. Our secondary outcomes were surgical complications, anastomotic leak, disease free survival and overall survival.
Results
Thirty-eight patients had surgery under 8 weeks (mean: 6 weeks) after their induction chemoradiation compared to 64 patients that had surgery after 8 weeks (mean: 10 weeks). There was no statistical significant difference between groups for the complete pathologic response (32% vs 25%, p = 0,16). Important complications were similar, with a rate of 24% vs 28% (p = 0,69). Anastomotic leaks were less frequent in the less than 8 weeks group, but no statistical significance was obtained (13% vs 27%, p = 0,14).No difference in the disease-free survival rate and overall survival rate was noted (DFS 40% vs 55% (p = 0,32), OS 38% vs 38% (p = 0,29)).
Conclusion
The treatment of esophageal cancer is in constant evolution, induction therapy and surgical technics involve over time. Surgical delay has no impact on complete pathologic response, complication and overall survival. There is no advantage to wait longer before surgery.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
The treatment of esophageal cancer is in constant evolution. Most of the esophageal cancer receive induction chemoradiation therapy. Surgical delay has been studied but the optimal timing ...has not been clarified. Through the years, surgical delay has been modified by surgeons in our institutions, going from an average of 6 weeks delay to an average of 10 weeks delay. It is time to ask if this change has a real positive impact on our patient.
Methods
In this retrospective multi-center study, we combined data from two center in Quebec city that performs oncologic esophagectomy. The surgical delay went from 6 to 10 weeks around 2014. All surgeons changed their practice at that moment. We retrospectively analysed 5 years before and after the change of practice and created two cohorts of patients. Our primary outcome compared complete pathologic response rate. Our secondary outcomes were surgical complications, anastomotic leak, disease free survival and overall survival.
Results
Thirty-eight patients had surgery under 8 weeks (mean: 6 weeks) after their induction chemoradiation compared to 64 patients that had surgery after 8 weeks (mean: 10 weeks). There was no statistical significant difference between groups for the complete pathologic response (32% vs 25%, p = 0,16). Important complications were similar, with a rate of 24% vs 28% (p = 0,69). Anastomotic leaks were less frequent in the less than 8 weeks group, but no statistical significance was obtained (13% vs 27%, p = 0,14). No difference in disease-free survival rate and overall survival rate was noted (DFS 40% vs 55% (p = 0,32), OS 38% vs 38% (p = 0,29)).
Conclusion
The treatment of esophageal cancer is in constant evolution, induction therapy and surgical technics involve over time. Surgical delay has no impact on complete pathologic response, complication and overall survival. There is no advantage to wait longer before surgery.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Nalaganje filtrov
Noben zadetek ni izbran!
Prosimo, izberite zadetke, ki jih želite izvoziti.
Iskanje je bilo uspešno shranjeno.
Urejanje
Iskanja ni bilo mogoče shraniti.
Shranjena iskanja si lahko ogledate v seznamu Moja iskanja.
Spremembe v shranjenem iskanju so uspešno shranjene.
Shrani iskanje
Vnos na polico
Noben zadetek ni izbran!
Dodajanje gradiva na polico je uspelo.
Dodajanje gradiva na polico je le deloma uspelo.
Dodajanje gradiva na polico je v celoti spodletelo.
Dodajanje gradiva na polico ni bilo potrebno.
Prosimo, izberite zadetke, ki jih želite dati na polico!
Na polico so bili uspešno dodani naslednji zapisi:
Na polico so bili uspešno dodani naslednji zapisi:
Vnosi, pri katerih je dodajanje na polico spodletelo:
Dodajanje na polico ni uspelo za vse izbrane vnose:
Vsa izbrana gradiva so že na polici.
Duplikat
Dosežena omejitev
Urejanje
Napaka
Urejanje
Dodajanje
Urejanje
Sprememba statusa
Opozorilo s to iskalno zahtevo že obstaja. Prosimo, preverite seznam Moja opozorila.
Imate že 10 aktivnih opozoril.
Pri urejanju opozorila ni bilo nobenih sprememb.
Pri dodajanju in/ali urejanju opozorila se je pojavila napaka. Prosimo, poskusite ponovno.
opac.user.alert.dialog.alert_success.info
Opozorilo je bilo uspešno dodano in aktivirano.
Spremembe v nastavitvah opozorila so uspešno shranjene.
