A comparison of the left thoracoabdominal and Ivor-Lewis esophagectomy

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
Andrew R DaviesRobert C Mason

Abstract

The purpose of this study was to assess the oncological outcomes of a large multicenter series of left thoracoabdominal esophagectomies, and compare these to the more widely utilized Ivor-Lewis esophagectomy. With ethics approval and an established study protocol, anonymized data from five centers were merged into a structured database. The study exposure was operative approach (ILE or LTE). The primary outcome measure was time to death. Secondary outcome measures included time to tumor recurrence, positive surgical resection margins, lymph node yield, postoperative death, and hospital length of stay. Cox proportional hazards models provided hazard ratios (HR) with 95% confidence intervals (CI) adjusting for age, pathological tumor stage, tumor grade, lymphovascular invasion, and neoadjuvant treatment. Among 1228 patients (598 ILE; 630 LTE), most (86%) had adenocarcinoma (AC) and were male (81%). Comparing ILE and LTE for AC patients, no difference was seen in terms of time to death (HR 0.904 95%CI 0.749-1.1090) or time to recurrence (HR 0.973 95%CI 0.768-1.232). The risk of a positive resection margin was also similar (OR 1.022 95%CI 0.731-1.429). Median lymph node yield did not differ between approaches (LTE 21; ILE 21; P = 0...Continue Reading

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Citations

Mar 5, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A ReyhaniJ A Gossage
Sep 23, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·P C MüllerC A Gutschow
Aug 7, 2018·BJS Open·W R C KnightUNKNOWN Guy's and St Thomas' Oesophago‐Gastric Research Group
Dec 12, 2018·British Journal of Nursing : BJN·Luca CardilloMieke Van Hemelrijck
Jun 28, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J A Gossage

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