Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer

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dc.contributor Chemaly, Rodrigue
dc.contributor.author Markar, Sheraz R.
dc.contributor.author Gronnier, Caroline
dc.contributor.author Duhamel, Alain
dc.contributor.author Pasquer, Arnaud
dc.contributor.author Théreaux, Jérémie
dc.contributor.author Du Rieu, Mael Chalret
dc.contributor.author Lefevre, Jérémie H.
dc.contributor.author Turner, Kathleen
dc.contributor.author Luc, Guillaume
dc.contributor.author Mariette, Christophe
dc.date.accessioned 2022-11-03T09:34:27Z
dc.date.available 2022-11-03T09:34:27Z
dc.date.copyright 2016 en_US
dc.date.issued 2022-11-03
dc.identifier.issn 0003-4932 en_US
dc.identifier.uri http://hdl.handle.net/10725/14209
dc.description.abstract Objective: The objectives of this study were to establish if R1 resection margin after esophagectomy was (i) a poor prognostic factor independent of patient and tumor characteristics, (ii) a marker of tumor aggressiveness and (iii) to look at the impact of adjuvant treatment in this subpopulation. Methods: Data were collected from 30 European centers from 2000 to 2010. Patients with an R1 resection margin (n = 242) were compared with those with an R0 margin (n = 2573) in terms of short- and long-term outcomes. Propensity score matching and multivariable analyses were used to compensate for differences in baseline characteristics. Results: Independent factors significantly associated with an R1 resection margin included an upper third esophageal tumor location, preoperative malnutrition, and pathological stage III. There were significant differences between the groups in postoperative histology, with an increase in pathological stage III and TRG 4–5 in the R1 group. Total average lymph node harvests were similar between the groups; however, there was an increase in the number of positive lymph nodes seen in the R1 group. Propensity matched analysis confirmed that R1 resection margin was significantly associated with reduced overall survival and increased overall, locoregional, and mixed tumor recurrence. Similar observations were seen in the subgroup that received neoadjuvant chemoradiation. In R1 patients adjuvant therapy improved survival and reduced distant recurrence however failed to affect locoregional recurrence. Conclusions: This large multicenter European study provides evidence to support the notion that R1 resection margin is a prognostic indication of aggressive tumor biology with a poor long-term prognosis. en_US
dc.language.iso en en_US
dc.title Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer en_US
dc.type Article en_US
dc.description.version Published 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 Surgery en_US
dc.journal.volume 263 en_US
dc.journal.issue 4 en_US
dc.article.pages 712-718 en_US
dc.keywords Esophageal cancer en_US
dc.keywords Morbidity en_US
dc.keywords Resection margin en_US
dc.keywords Surgery en_US
dc.keywords Survival en_US
dc.identifier.doi https://doi.org/10.1097/SLA.0000000000001325 en_US
dc.identifier.ctation Markar, S. R., Gronnier, C., Duhamel, A., Pasquer, A., Théreaux, J., Rieu, M. C. D., ... & Mariette, C. (2016). Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer. Annals of surgery, 263(4), 712-718. 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://pubmed.ncbi.nlm.nih.gov/26135681/ en_US
dc.note Collaborators: FREGAT Working Group-FRENCH-AFC en_US
dc.orcid.id https://orcid.org/0000-0002-3670-6027 en_US
dc.author.affiliation Lebanese American University en_US

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