Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy
Abstract Objectives The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer undergoing a totally minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital. Methods This wa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02518-0 |
| _version_ | 1818981874779815936 |
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| author | Keouna Pather Erin M. Mobley Christina Guerrier Rhemar Esma Heather Kendall Ziad T. Awad |
| author_facet | Keouna Pather Erin M. Mobley Christina Guerrier Rhemar Esma Heather Kendall Ziad T. Awad |
| author_sort | Keouna Pather |
| collection | DOAJ |
| description | Abstract Objectives The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer undergoing a totally minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital. Methods This was a single-center retrospective review of consecutive patients who underwent MILE from September 2013 to November 2017. Overall and disease-free survival were analyzed by Kaplan-Meier estimates, and hazard ratios (HR) were derived from multivariable Cox regression models. Results Ninety-six patients underwent MILE during the study period. Overall survival at 1, 3, and 5 years was 83.2%, 61.9%, and 55.9%, respectively. Disease-free survival at 1, 3, and 5 years was 83.2%, 60.6%, and 47.5%, respectively. Overall survival (p < 0.001) and disease-free survival (p < 0.001) differed across pathological stages. By multivariable analysis, increasing age (HR, 1.06; p = 0.02), decreasing Karnofsky performance status score (HR, 0.94; p = 0.002), presence of stage IV disease (HR, 5.62; p = 0.002), locoregional recurrence (HR, 2.94; p = 0.03), and distant recurrence (HR, 4.78; p < 0.001) were negatively associated with overall survival. Overall survival significantly declined within 2 years and was independently associated with stage IV disease (HR, 3.29; p = 0.04) and distant recurrence (HR, 5.78; p < 0.001). Conclusion MILE offers favorable long-term overall and disease-free survival outcomes. Age, Karnofsky performance status score, stage IV, and disease recurrence are shown to be prognostic factors of overall survival. Prospective studies comparing long-term outcomes after different MIE approaches are warranted to validate survival outcomes after MILE. |
| first_indexed | 2024-12-20T17:38:15Z |
| format | Article |
| id | doaj.art-19ed84479e9f46a7a02eb9fb43a935a3 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-20T17:38:15Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-19ed84479e9f46a7a02eb9fb43a935a32022-12-21T19:31:10ZengBMCWorld Journal of Surgical Oncology1477-78192022-02-0120111410.1186/s12957-022-02518-0Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomyKeouna Pather0Erin M. Mobley1Christina Guerrier2Rhemar Esma3Heather Kendall4Ziad T. Awad5Department of Surgery, University of Florida College of Medicine – JacksonvilleDepartment of Surgery, University of Florida College of Medicine – JacksonvilleDepartment of Surgery, University of Florida College of Medicine – JacksonvilleUF Health Jacksonville, JacksonvilleUF Health Jacksonville, JacksonvilleDepartment of Surgery, University of Florida College of Medicine – JacksonvilleAbstract Objectives The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer undergoing a totally minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital. Methods This was a single-center retrospective review of consecutive patients who underwent MILE from September 2013 to November 2017. Overall and disease-free survival were analyzed by Kaplan-Meier estimates, and hazard ratios (HR) were derived from multivariable Cox regression models. Results Ninety-six patients underwent MILE during the study period. Overall survival at 1, 3, and 5 years was 83.2%, 61.9%, and 55.9%, respectively. Disease-free survival at 1, 3, and 5 years was 83.2%, 60.6%, and 47.5%, respectively. Overall survival (p < 0.001) and disease-free survival (p < 0.001) differed across pathological stages. By multivariable analysis, increasing age (HR, 1.06; p = 0.02), decreasing Karnofsky performance status score (HR, 0.94; p = 0.002), presence of stage IV disease (HR, 5.62; p = 0.002), locoregional recurrence (HR, 2.94; p = 0.03), and distant recurrence (HR, 4.78; p < 0.001) were negatively associated with overall survival. Overall survival significantly declined within 2 years and was independently associated with stage IV disease (HR, 3.29; p = 0.04) and distant recurrence (HR, 5.78; p < 0.001). Conclusion MILE offers favorable long-term overall and disease-free survival outcomes. Age, Karnofsky performance status score, stage IV, and disease recurrence are shown to be prognostic factors of overall survival. Prospective studies comparing long-term outcomes after different MIE approaches are warranted to validate survival outcomes after MILE.https://doi.org/10.1186/s12957-022-02518-0Esophageal malignancyThoracic surgeryThoracolaparoscopic esophagectomyIvor Lewis esophagectomyCancer survival |
| spellingShingle | Keouna Pather Erin M. Mobley Christina Guerrier Rhemar Esma Heather Kendall Ziad T. Awad Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy World Journal of Surgical Oncology Esophageal malignancy Thoracic surgery Thoracolaparoscopic esophagectomy Ivor Lewis esophagectomy Cancer survival |
| title | Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy |
| title_full | Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy |
| title_fullStr | Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy |
| title_full_unstemmed | Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy |
| title_short | Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy |
| title_sort | long term survival outcomes of esophageal cancer after minimally invasive ivor lewis esophagectomy |
| topic | Esophageal malignancy Thoracic surgery Thoracolaparoscopic esophagectomy Ivor Lewis esophagectomy Cancer survival |
| url | https://doi.org/10.1186/s12957-022-02518-0 |
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