医学
多西紫杉醇
食管癌
养生
西妥昔单抗
淋巴结
内科学
新辅助治疗
癌症
外科
化疗
食管切除术
结直肠癌
放化疗
乳腺癌
作者
Urs von Holzen,Sven Schmidt,Stefanie Hayoz,Thomas Steffen,Felix Grieder,Detlef K. Bartsch,Annelies Schnider,W. T. Knoefel,Guillaume Piessen,Christoph Kettelhack,Walter R. Marti,Markus Schäfer,R. Függer,Alfred Köigsrainer,Beat Gloor,Markus Furrer,Marie-Aline Gérard,Hanne Hawle,Martin K. Walz,Pier Francesco Alesina,Thomas Ruhstaller
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2020-08-26
卷期号:275 (6): 1130-1136
被引量:4
标识
DOI:10.1097/sla.0000000000004334
摘要
To assess the impact of surgical technique in regard to morbidity and mortality after neoadjuvant treatment for esophageal cancer.The SAKK trial 75/08 was a multicenter phase III trial (NCT01107639) comparing induction chemotherapy followed by chemoradiation and surgery in patients with locally advanced esophageal cancer.Patients in the control arm received induction chemotherapy with cisplatin and docetaxel, followed by concomitant chemoradiation therapy with cisplatin, docetaxel, and 45Gy. In the experimental arm, the same regimen was used with addition of cetuximab. After completion of neoadjuvant treatment, patients underwent esophagectomy. The experimental arm received adjuvant cetuximab. Surgical outcomes and complications were prospectively recorded and analyzed.Total of 259 patients underwent esophagectomy. Overall complication rate was 56% and reoperation rate was 15% with no difference in complication rates for transthoracic versus transhiatal resections (56% vs 54%, P = 0.77), nor for video assisted thoracic surgeries (VATS) versus open transthoracic resections (67% vs 55%, P = 0.32). There was a trend to higher overall complication rates in squamous cell carcinoma versus adenocarcinoma (65% vs 51%, P = 0.035), and a significant difference in ARDS in squamous cell carcinoma with 14% versus 2% in adenocarcinoma (P = 0.0002). For patients with involved lymph nodes, a lymph node ratio of ≥0.1 was an independent predictor of PFS (HR 2.5, P = 0.01) and OS (HR 2.2, P = 0.03).This trial showed no difference in surgical complication rates between transthoracic and transhiatal resections. For patients with involved lymph nodes, lymph node ratio was an independent predictor of progression free survival and overall survival.
科研通智能强力驱动
Strongly Powered by AbleSci AI