Universität zu Köln

Plum, Patrick Sven, Hoelscher, Arnulf Heinrich, Godoy, Kristin Pacheco, Schmidt, Henner, Berlth, Felix ORCID: 0000-0002-3780-0728, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Alakus, Hakan and Bollschweiler, Elfriede (2018). Prognosis of patients with superficial T1 esophageal cancer who underwent endoscopic resection before esophagectomy-A propensity score-matched comparison. Surg. Endosc., 32 (9). S. 3972 - 3981. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

Background The aim of this retrospective study was to compare the prognosis of patients with esophageal cancer after non-curative endoscopic resection (ER) followed by esophagectomy (ER + S) with that of patients after primary surgery (PS). Methods Between 2000 and 2015, 287 patients had esophagectomy for T1 esophageal cancer. 81 of these patients underwent at least one ER in curative intention before surgery (7 squamous cell carcinomas, 74 adenocarcinomas). Indications for esophagectomy were Rl-resection, submucosal infiltration, multifocality, long-segment Barrett esophagus, recurrence, postinterventional stenosis or a combination of these factors. Using propensity-score matching with gender, age, year of diagnosis, tumor localization, mucosal/submucosal infiltration and histology, the clinicopathologic and survival data of these patients were compared to those of 81 patients after PS (median follow-up: 5.5 years). Results There were no significant differences between both groups concerning number of resected lymph nodes and percentage of nodal metastasis (9.3% total). 9% of esophagectomy specimens after ER showed pT2/pT3-tumors. The 5-year survival rate was 86% in the PS and 85% in the ER + S group (p = 0 .498). The disease-free survival was 85% in patients with ER+ S and 98% in PS (p < 0.005). The recurrence rate after esophagectomy was higher after ER + S compared to PS (p = 0.015). More than 3 months time delay between ER and surgery was associated with reduced survival, but only within the first postinterventional year. Conclusions As the disease-free survival was inferior in the ER + S compared to the PS group the indication for ER, especially repeated ERs, should be restricted to cases with high expectation of success.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Plum, Patrick Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Godoy, Kristin Pacheco UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Henner UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, Felix UNSPECIFIED orcid.org/0000-0002-3780-0728 UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-175831
DOI:	10.1007/s00464-018-6139-7
Journal or Publication Title:	Surg. Endosc.
Volume:	32
Number:	9
Page Range:	S. 3972 - 3981
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; HIGH-GRADE DYSPLASIA; BARRETTS-ESOPHAGUS; MERENDINO PROCEDURE; SURGICAL RESECTION; ADENOCARCINOMA; MUCOSAL; THERAPY; RISK; MULTICENTER Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17583