Cancer of esophagus and GE junction– a long-term follow-up results
Background: Esophageal and GE Junction malignancies are diagnosed late and the long-term outcome is still suboptimal. We present our experience. Methods: 421 patients with mean age of 57.6 years with cancer of esophagus and GE Junction were evaluated with physical examination, CT chest and abdomen...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Society of Surgeons of Nepal
2016-07-01
|
| Series: | Journal of Society of Surgeons of Nepal |
| Online Access: | https://www.nepjol.info/index.php/JSSN/article/view/15284 |
| _version_ | 1818889226280763392 |
|---|---|
| author | Binay Thakur Di Yonghui Mukti Devkota Paribartan Baral Sudhir Shrestha Janaki Upreti Nirmala Kandel |
| author_facet | Binay Thakur Di Yonghui Mukti Devkota Paribartan Baral Sudhir Shrestha Janaki Upreti Nirmala Kandel |
| author_sort | Binay Thakur |
| collection | DOAJ |
| description | Background: Esophageal and GE Junction malignancies are diagnosed late and the long-term outcome is still suboptimal. We present our experience.
Methods: 421 patients with mean age of 57.6 years with cancer of esophagus and GE Junction were evaluated with physical examination, CT chest and abdomen, gastroduodenoscopy and bronchoscopy. 254 (60.4%) patients underwent surgical treatment only and 167 (39.6%) underwent multimodality treatment. 295 patients underwent transthoracic approach, 88 – transhiatal approach and 58 patients underwent – abdominal approach only.
Results: Upper, middle, GEJ type – I, GEJ type – II, GEJ type – III tumors were present in 5.7, 28.5, 36.8 and 1.9% cases, respectively. Anastomosis was placed at neck in 73.2% and in chest in 26.8% cases. Final stages were 0 (0.2%), Ia (0.5%), Ib (1.9%), IIa (10%), IIb (8.8%), IIIa (15.7%), IIIb (14.3%), IIIc (41.6%) and IV (7.1%). R0 resection was achieved in 91.5% cases. Postoperative mortality, recurrent laryngeal nerve injury, anastomotic leak and pneumonia were observed in 4.8%, 5.7%, 11.6% and 22.1%, respectively. Median overall survival was 28 months with 5-year overall survival of 21%. A subgroup of 70 patients (16.6%) who were subjected to preoperative chemoradiation followed by surgery showed response in 64.3% cases with a median and 5-year survival of 49 months and 30% in responders, and 15 months and 15% in non-responders.
Conclusion: Patients presented mostly in stage III (78.7%), therefore a multimodality approach should be considered as a standard practice in Nepalese context in order to achieve better survival results. |
| first_indexed | 2024-12-19T17:05:39Z |
| format | Article |
| id | doaj.art-ba383eac5eaa469989be0fd7c96960b2 |
| institution | Directory Open Access Journal |
| issn | 1815-3984 2392-4772 |
| language | English |
| last_indexed | 2024-12-19T17:05:39Z |
| publishDate | 2016-07-01 |
| publisher | Society of Surgeons of Nepal |
| record_format | Article |
| series | Journal of Society of Surgeons of Nepal |
| spelling | doaj.art-ba383eac5eaa469989be0fd7c96960b22022-12-21T20:13:10ZengSociety of Surgeons of NepalJournal of Society of Surgeons of Nepal1815-39842392-47722016-07-0118310.3126/jssn.v18i3.15284Cancer of esophagus and GE junction– a long-term follow-up resultsBinay ThakurDi YonghuiMukti DevkotaParibartan BaralSudhir ShresthaJanaki UpretiNirmala KandelBackground: Esophageal and GE Junction malignancies are diagnosed late and the long-term outcome is still suboptimal. We present our experience. Methods: 421 patients with mean age of 57.6 years with cancer of esophagus and GE Junction were evaluated with physical examination, CT chest and abdomen, gastroduodenoscopy and bronchoscopy. 254 (60.4%) patients underwent surgical treatment only and 167 (39.6%) underwent multimodality treatment. 295 patients underwent transthoracic approach, 88 – transhiatal approach and 58 patients underwent – abdominal approach only. Results: Upper, middle, GEJ type – I, GEJ type – II, GEJ type – III tumors were present in 5.7, 28.5, 36.8 and 1.9% cases, respectively. Anastomosis was placed at neck in 73.2% and in chest in 26.8% cases. Final stages were 0 (0.2%), Ia (0.5%), Ib (1.9%), IIa (10%), IIb (8.8%), IIIa (15.7%), IIIb (14.3%), IIIc (41.6%) and IV (7.1%). R0 resection was achieved in 91.5% cases. Postoperative mortality, recurrent laryngeal nerve injury, anastomotic leak and pneumonia were observed in 4.8%, 5.7%, 11.6% and 22.1%, respectively. Median overall survival was 28 months with 5-year overall survival of 21%. A subgroup of 70 patients (16.6%) who were subjected to preoperative chemoradiation followed by surgery showed response in 64.3% cases with a median and 5-year survival of 49 months and 30% in responders, and 15 months and 15% in non-responders. Conclusion: Patients presented mostly in stage III (78.7%), therefore a multimodality approach should be considered as a standard practice in Nepalese context in order to achieve better survival results.https://www.nepjol.info/index.php/JSSN/article/view/15284 |
| spellingShingle | Binay Thakur Di Yonghui Mukti Devkota Paribartan Baral Sudhir Shrestha Janaki Upreti Nirmala Kandel Cancer of esophagus and GE junction– a long-term follow-up results Journal of Society of Surgeons of Nepal |
| title | Cancer of esophagus and GE junction– a long-term follow-up results |
| title_full | Cancer of esophagus and GE junction– a long-term follow-up results |
| title_fullStr | Cancer of esophagus and GE junction– a long-term follow-up results |
| title_full_unstemmed | Cancer of esophagus and GE junction– a long-term follow-up results |
| title_short | Cancer of esophagus and GE junction– a long-term follow-up results |
| title_sort | cancer of esophagus and ge junction a long term follow up results |
| url | https://www.nepjol.info/index.php/JSSN/article/view/15284 |
| work_keys_str_mv | AT binaythakur cancerofesophagusandgejunctionalongtermfollowupresults AT diyonghui cancerofesophagusandgejunctionalongtermfollowupresults AT muktidevkota cancerofesophagusandgejunctionalongtermfollowupresults AT paribartanbaral cancerofesophagusandgejunctionalongtermfollowupresults AT sudhirshrestha cancerofesophagusandgejunctionalongtermfollowupresults AT janakiupreti cancerofesophagusandgejunctionalongtermfollowupresults AT nirmalakandel cancerofesophagusandgejunctionalongtermfollowupresults |