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

Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early... Background 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. Methods 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. Results 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% http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Surgery Springer Journals

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

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Société Internationale de Chirurgie
Subject
Medicine & Public Health; Surgery; Abdominal Surgery; Cardiac Surgery; General Surgery; Thoracic Surgery; Vascular Surgery
ISSN
0364-2313
eISSN
1432-2323
D.O.I.
10.1007/s00268-017-4422-8
Publisher site
See Article on Publisher Site

Abstract

Background 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. Methods 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. Results 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%

Journal

World Journal of SurgerySpringer Journals

Published: Dec 28, 2017

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