Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer.

Details

Serval ID
serval:BIB_431ABD6584EC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer.
Journal
World journal of surgery
Author(s)
Mantziari S., Allemann P., Winiker M., Demartines N., Schäfer M.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
07/2018
Peer-reviewed
Oui
Volume
42
Number
7
Pages
2209-2217
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
Tumor recurrence during the first year after oncological esophagectomy has been reported in up to 17-66% of patients. However, little is known as to the risk factors potentially associated with this adverse outcome. The aim of this retrospective observational study was to identify clinically relevant parameters associated with early recurrence.
All patients with squamous cell cancer or adenocarcinoma of the esophagus or gastroesophageal junction, operated with curative intent in our center from 2000 to 2014, were screened for this study. Univariate analysis was conducted to identify variables potentially associated with early recurrence, and clinically relevant parameters with P < 0.1 were included in multiple logistic regression. Survival analyses were conducted with the Kaplan-Meier method. Significance threshold was set at P < 0.05.
Among the 164 included patients, 46 (28%) presented early recurrence. Eight patients (17.4%) had locoregional and 38 patients (82.6%) metastatic recurrence. Advanced T and N stages, lymph node capsular effraction, a high positive-to-resected lymph node ratio, positive resection margins, poor response to neoadjuvant treatment, preoperative active smoking, malnutrition and dysphagia were associated with early recurrence on a univariate level. In multivariable analysis, preoperative smoking (OR 2.76, 95% CI 1.28-6.17), pT stage (OR 1.72, 95% CI 1.18-2.58) and an increased positive-to-resected lymph node ratio (OR 6.72, 95% CI 1.08-48.51) remained independently associated with ER.
Our study identified both patient- and tumor-related parameters as risk factors for early recurrence after oncological esophagectomy. Of particular interest, active smoking was significantly associated with this adverse outcome, highlighting the importance of preoperative smoking cessation.
Keywords
Adenocarcinoma/secondary, Adenocarcinoma/surgery, Aged, Carcinoma, Squamous Cell/secondary, Carcinoma, Squamous Cell/surgery, Esophageal Neoplasms/pathology, Esophageal Neoplasms/surgery, Esophagectomy, Esophagogastric Junction, Female, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Lymph Nodes/pathology, Lymph Nodes/surgery, Lymphatic Metastasis, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local/pathology, Neoplasm Staging, Preoperative Period, Retrospective Studies, Risk Factors, Smoking/adverse effects
Pubmed
Web of science
Create date
25/01/2018 19:44
Last modification date
26/09/2019 22:11
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