Surgical factors influencing outcomes in patients resected for cancer of the esophagus or gastric cardia.

World Journal of Surgery
Martin SundelöfWeimin Ye

Abstract

Surgery is the treatment of choice for localized esophageal and gastric cardia cancer. Our aim was to evaluate factors influencing postoperative short-term morbidity, 30-day mortality, and long-term prognosis. We identified 232 patients who had undergone surgical resection from a Swedish nationwide case control study of cancer of the esophagus and cardia between December 1, 1994 and December 31, 1997. Patients' demographics, tumor characteristics, preoperative investigations, and treatments were reviewed. Patients were followed up through linkage to the Death Registry until December 2004. Survival curves were estimated by the Kaplan-Meier method. Cox proportional hazards regression models were used to derive hazard ratios (HRs) with 95% confidence intervals (CIs). The overall 5-year survival rate was 25%. Tumor stage was the most prominent prognostic factor for long-term survival. Low-volume hospital (HR = 1.3, 95% CI = 1.0-1.9), low-volume surgeon (HR = 1.4, 95% CI = 1.0-2.0), and postoperative need for respirator support (HR = 1.4, 95% CI = 1.0-1.9), were associated with a worse prognosis. Patients treated at low-volume hospitals or by low-volume surgeons needed respirator support more often or stayed longer at intensive care...Continue Reading

References

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Citations

Jul 11, 2013·Annals of Surgical Oncology·Lawrence LeeLorenzo E Ferri
Nov 19, 2013·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·I HarirchiK Zendehdel
Oct 5, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Po-Kuei HsuChia-Chuan Liu
Mar 5, 2013·Surgical Oncology Clinics of North America·Charles R Mulligan
Jan 9, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Maryam DerogarJesper Lagergren
Feb 11, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Petra GanschowChristoph Schulz

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