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 abdome...

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Autores principales:	Binay Thakur, Di Yonghui, Mukti Devkota, Paribartan Baral, Sudhir Shrestha, Janaki Upreti, Nirmala Kandel
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/ba383eac5eaa469989be0fd7c96960b2
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spelling	oai:doaj.org-article:ba383eac5eaa469989be0fd7c96960b22021-12-05T19:16:42ZCancer of esophagus and GE junction– a long-term follow-up results10.3126/jssn.v18i3.152841815-39842392-4772https://doaj.org/article/ba383eac5eaa469989be0fd7c96960b22016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15284https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 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. Binay ThakurDi YonghuiMukti DevkotaParibartan BaralSudhir ShresthaJanaki UpretiNirmala KandelSociety of Surgeons of NepalarticleSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 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
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.
format	article
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
title	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_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_sort	cancer of esophagus and ge junction– a long-term follow-up results
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/ba383eac5eaa469989be0fd7c96960b2
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
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Cancer of esophagus and GE junction– a long-term follow-up results

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