Salvage surgery for esophageal cancer

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dc.contributor Chemaly, Rodrigue
dc.contributor.author Cohen, Charlotte
dc.contributor.author Tessier, Williams
dc.contributor.author Gronnier, Caroline
dc.contributor.author Renaud, Florence
dc.contributor.author Pasquer, Arnaud
dc.contributor.author Théreaux, Jérémie
dc.contributor.author Gagniere, Johan
dc.contributor.author Meunier, Bernard
dc.contributor.author Collet, Denis
dc.contributor.author Piessen, Guillaume
dc.contributor.author Mariette, Christophe
dc.date.accessioned 2022-11-02T12:52:54Z
dc.date.available 2022-11-02T12:52:54Z
dc.date.copyright 2018 en_US
dc.date.issued 2022-11-02
dc.identifier.issn 1068-9265 en_US
dc.identifier.uri http://hdl.handle.net/10725/14207
dc.description.abstract Background Locoregional recurrence rates after definitive chemoradiotherapy (dCRT) for locally advanced esophageal cancer (EC) are high. Salvage surgery (SALV) is considered the best treatment option in case of persistent or recurrent disease for operable patients, but SALV has been associated with increased morbidity and mortality. The aim of this study is to identify factors linked to outcomes after SALV to better select candidates and to optimize perioperative care. Study Design We retrospectively analyzed data from 308 consecutive SALV patients from a large multicenter European cohort. Univariate and multivariate analyses were performed to identify factors associated with in-hospital postoperative morbidity, anastomotic leakage (AL), and overall survival (OS). Results The in-hospital postoperative mortality and morbidity rates were 8.4 and 34.7%, respectively. Squamous cell histology (p = 0.040) and radiation dose ≥ 55 Gy (p = 0.047) were independently associated with major morbidity. The AL rate was 12.7%, and cervical anastomosis was independently associated with AL (p = 0.002). OS at 5 years was 34.0%. Radiation dose ≥ 55 Gy (p = 0.003), occurrence of postoperative complications (p = 0.006), ypTNM stage 3 (p = 0.019), and positive surgical margins (p < 0.001) were linked to poor prognosis. Conclusions SALV is a valuable option for patients with persistent or recurrent disease after dCRT and offers long-term survival. Factors such as radiation dose and anastomosis location identified here will help to optimize outcomes after SALV, which may be considered a standard treatment in the EC therapeutic armamentarium. en_US
dc.language.iso en en_US
dc.title Salvage surgery for esophageal cancer en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle how to improve outcomes? en_US
dc.author.school SOM en_US
dc.author.idnumber 201805037 en_US
dc.author.department N/A en_US
dc.relation.journal Annals of Surgical Oncology en_US
dc.journal.volume 25 en_US
dc.journal.issue 5 en_US
dc.article.pages 1277-1286 en_US
dc.keywords Esophageal Cancer en_US
dc.keywords Definitive Chemoradiotherapy en_US
dc.keywords ypTNM Stage en_US
dc.keywords Cervical Anastomosis en_US
dc.keywords Anastomosis Location en_US
dc.identifier.doi https://doi.org/10.1245/s10434-018-6365-1 en_US
dc.identifier.ctation Cohen, C., Tessier, W., Gronnier, C., Renaud, F., Pasquer, A., Théreaux, J., ... & Mariette, C. (2018). Salvage surgery for esophageal cancer: how to improve outcomes?. Annals of surgical oncology, 25(5), 1277-1286. en_US
dc.author.email rodrigue.chemaly@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://link.springer.com/article/10.1245/s10434-018-6365-1 en_US
dc.note Collaborators of the FREGAT (French Eso-Gastric Tumors working group) – FRENCH (Fédération de Recherche en Chirurgie) – AFC (Association Française de Chirurgie) Working Groups are listed in “Acknowledgment”
dc.orcid.id https://orcid.org/0000-0002-3670-6027 en_US
dc.author.affiliation Lebanese American University en_US

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