Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies
Objective:. To clarify the surgical outcomes of esophagectomy in Japan and comprehensively evaluate trends over time. It is important to analyze data from a large number of consecutive patients from a single institution. Methods:. We evaluated the treatment outcomes, complications, and prognosis of...
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Wolters Kluwer Health
2023-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000347 |
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| author | Yasue Kimura, MD, PhD Eiji Oki, MD, PhD Tomonori Nakanoko, MD, PhD Qingjiang Hu, MD, PhD Keita Natsugoe, MD Sho Nanbara, MD, PhD Ryota Nakanishi, MD, PhD Yuichiro Nakashima, MD, PhD Mitsuhiko Ota, MD, PhD Tomoharu Yoshizumi, MD, PhD |
| author_facet | Yasue Kimura, MD, PhD Eiji Oki, MD, PhD Tomonori Nakanoko, MD, PhD Qingjiang Hu, MD, PhD Keita Natsugoe, MD Sho Nanbara, MD, PhD Ryota Nakanishi, MD, PhD Yuichiro Nakashima, MD, PhD Mitsuhiko Ota, MD, PhD Tomoharu Yoshizumi, MD, PhD |
| author_sort | Yasue Kimura, MD, PhD |
| collection | DOAJ |
| description | Objective:. To clarify the surgical outcomes of esophagectomy in Japan and comprehensively evaluate trends over time. It is important to analyze data from a large number of consecutive patients from a single institution.
Methods:. We evaluated the treatment outcomes, complications, and prognosis of 1500 consecutive patients who underwent esophagectomy during 5 periods: group A (n = 284), 1964–1984; group B (n = 345), 1985–1993; group C (n = 253), 1994–2002; group D (n = 297), 2003–2012; and group E (n = 321), 2013–March 2020.
Results:. The incidences of squamous cell carcinoma and adenocarcinoma were 93.8% and 3.3%, respectively. The proportion of adenocarcinoma cases has gradually increased over time. The in-hospital mortality rates for groups A, B, C, D, and E were 12%, 4.6%, 1.2%, 2.9%, and 1.5%, respectively. Group A had a significantly higher mortality rate than the other groups (P < 0.0001). Three-year survival rates were 22.2%, 47.8%, 53.4%, 69.9%, and 72.6% in groups A–E, respectively, 5-year survival rates were 17.2%, 41.3%, 49.2%, 63.9%, and 68.4%, respectively (P < 0.0001, group A vs groups D and E). The prognosis improved over time. Multivariate analysis revealed that depth of invasion, lymph node metastasis, the extent of lymph node resection, curative resection, pulmonary complications, and anastomotic leakage were significant independent prognostic factors. However, for recent surgeries (groups D and E), only the depth of invasion, lymph node metastasis, and curative resection were significant independent prognostic factors.
Conclusions:. Valuable changes in background and prognostic factors occurred over time. These findings will help optimize esophageal cancer management and improve patient outcomes. |
| format | Article |
| id | doaj-art-1c33e463962a4b0daa50d3ea8723f39a |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer Health |
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| series | Annals of Surgery Open |
| spelling | doaj-art-1c33e463962a4b0daa50d3ea8723f39a2025-01-24T09:18:12ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932023-12-0144e34710.1097/AS9.0000000000000347202312000-00008Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive EsophagostomiesYasue Kimura, MD, PhD0Eiji Oki, MD, PhD1Tomonori Nakanoko, MD, PhD2Qingjiang Hu, MD, PhD3Keita Natsugoe, MD4Sho Nanbara, MD, PhD5Ryota Nakanishi, MD, PhD6Yuichiro Nakashima, MD, PhD7Mitsuhiko Ota, MD, PhD8Tomoharu Yoshizumi, MD, PhD9From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.From the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.Objective:. To clarify the surgical outcomes of esophagectomy in Japan and comprehensively evaluate trends over time. It is important to analyze data from a large number of consecutive patients from a single institution. Methods:. We evaluated the treatment outcomes, complications, and prognosis of 1500 consecutive patients who underwent esophagectomy during 5 periods: group A (n = 284), 1964–1984; group B (n = 345), 1985–1993; group C (n = 253), 1994–2002; group D (n = 297), 2003–2012; and group E (n = 321), 2013–March 2020. Results:. The incidences of squamous cell carcinoma and adenocarcinoma were 93.8% and 3.3%, respectively. The proportion of adenocarcinoma cases has gradually increased over time. The in-hospital mortality rates for groups A, B, C, D, and E were 12%, 4.6%, 1.2%, 2.9%, and 1.5%, respectively. Group A had a significantly higher mortality rate than the other groups (P < 0.0001). Three-year survival rates were 22.2%, 47.8%, 53.4%, 69.9%, and 72.6% in groups A–E, respectively, 5-year survival rates were 17.2%, 41.3%, 49.2%, 63.9%, and 68.4%, respectively (P < 0.0001, group A vs groups D and E). The prognosis improved over time. Multivariate analysis revealed that depth of invasion, lymph node metastasis, the extent of lymph node resection, curative resection, pulmonary complications, and anastomotic leakage were significant independent prognostic factors. However, for recent surgeries (groups D and E), only the depth of invasion, lymph node metastasis, and curative resection were significant independent prognostic factors. Conclusions:. Valuable changes in background and prognostic factors occurred over time. These findings will help optimize esophageal cancer management and improve patient outcomes.http://journals.lww.com/10.1097/AS9.0000000000000347 |
| spellingShingle | Yasue Kimura, MD, PhD Eiji Oki, MD, PhD Tomonori Nakanoko, MD, PhD Qingjiang Hu, MD, PhD Keita Natsugoe, MD Sho Nanbara, MD, PhD Ryota Nakanishi, MD, PhD Yuichiro Nakashima, MD, PhD Mitsuhiko Ota, MD, PhD Tomoharu Yoshizumi, MD, PhD Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies Annals of Surgery Open |
| title | Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies |
| title_full | Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies |
| title_fullStr | Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies |
| title_full_unstemmed | Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies |
| title_short | Evolution of Treatment Outcomes and Prognostic Factors in Esophageal Cancer Surgery: A Retrospective Analysis of 1500 Consecutive Esophagostomies |
| title_sort | evolution of treatment outcomes and prognostic factors in esophageal cancer surgery a retrospective analysis of 1500 consecutive esophagostomies |
| url | http://journals.lww.com/10.1097/AS9.0000000000000347 |
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