TY - JOUR
T1 - Improved Clinical and Survival Outcomes After Esophagectomy for Cancer Over 25 Years
AU - Slaman, Annelijn E.
AU - Pirozzolo, Giovanni
AU - Eshuis, Wietse J.
AU - Bergman, Jacques J. G. H. M.
AU - Hulshof, Maarten C. C. M.
AU - van Laarhoven, Hanneke W. M.
AU - Meijer, Sybren L.
AU - Gisbertz, Suzanne S.
AU - van Berge Henegouwen, Mark I.
N1 - Publisher Copyright: © 2022 The Society of Thoracic Surgeons
PY - 2022/10
Y1 - 2022/10
N2 - Background: In recent decades, there have been major developments in the curative treatment of esophageal cancer, such as the implementation of positron emission tomography with computed tomography, neoadjuvant chemoradiotherapy, minimally invasive surgery, and postoperative care programs. This observational study examined clinical and survival outcomes after esophagectomy for cancer over 25 years. Methods: Consecutive patients who underwent esophagectomy for cancer at a tertiary referral center between 1993 and 2018 were selected from a prospectively maintained database. Patients were assigned to 5 periods: 1993 to 1997, 1998 to 2002, 2003 to 2007, 2008 to 2012, and 2013 to 2017. The primary outcome was 5-year overall survival by using Kaplan–Meier log-rank tests for trends. Results: A total of 1616 patients were analyzed. The median follow-up of surviving patients was 91.0 months (interquartile range [IQR], 62.6-127.5 months).The 5-year overall survival improved gradually from 32.8% to 48.2% over 25 years (P < .001). Hospital length of stay decreased from 16 days (median IQR, 14-24 days) in 1993 to 1997 to 11 days (IQR, 8-18 days) in 2013 to 2017 (P < .001). No decrease in mortality was encountered over 25 years, although over the last 5 years, in-hospital and 90-day mortality dropped from 4.2% and 8.3% in 2013 to 0% in 2017 (P < .05). Anastomotic leakages decreased from 26.4% to 9.7% between 2013 and 2017 (P < .001). Conclusions: Over the last 25 years, clinical outcomes and 5-year overall survival significantly improved in patients who underwent esophagectomy for cancer at this tertiary referral center.
AB - Background: In recent decades, there have been major developments in the curative treatment of esophageal cancer, such as the implementation of positron emission tomography with computed tomography, neoadjuvant chemoradiotherapy, minimally invasive surgery, and postoperative care programs. This observational study examined clinical and survival outcomes after esophagectomy for cancer over 25 years. Methods: Consecutive patients who underwent esophagectomy for cancer at a tertiary referral center between 1993 and 2018 were selected from a prospectively maintained database. Patients were assigned to 5 periods: 1993 to 1997, 1998 to 2002, 2003 to 2007, 2008 to 2012, and 2013 to 2017. The primary outcome was 5-year overall survival by using Kaplan–Meier log-rank tests for trends. Results: A total of 1616 patients were analyzed. The median follow-up of surviving patients was 91.0 months (interquartile range [IQR], 62.6-127.5 months).The 5-year overall survival improved gradually from 32.8% to 48.2% over 25 years (P < .001). Hospital length of stay decreased from 16 days (median IQR, 14-24 days) in 1993 to 1997 to 11 days (IQR, 8-18 days) in 2013 to 2017 (P < .001). No decrease in mortality was encountered over 25 years, although over the last 5 years, in-hospital and 90-day mortality dropped from 4.2% and 8.3% in 2013 to 0% in 2017 (P < .05). Anastomotic leakages decreased from 26.4% to 9.7% between 2013 and 2017 (P < .001). Conclusions: Over the last 25 years, clinical outcomes and 5-year overall survival significantly improved in patients who underwent esophagectomy for cancer at this tertiary referral center.
UR - http://www.scopus.com/inward/record.url?scp=85130887748&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.athoracsur.2022.02.085
DO - https://doi.org/10.1016/j.athoracsur.2022.02.085
M3 - Article
C2 - 35421354
SN - 0003-4975
VL - 114
SP - 1118
EP - 1126
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -