TY - JOUR
T1 - Resection of hepatic and pulmonary metastasis from metastatic esophageal and gastric cancer: a nationwide study
T2 - A nationwide study
AU - Gastroesophageal Metastasectomy Group
AU - Seesing, M. F. J.
AU - van der Veen, A.
AU - Brenkman, H. J. F.
AU - Stockmann, H. B. A. C.
AU - Nieuwenhuijzen, G. A. P.
AU - Rosman, C.
AU - van den Wildenberg, F. J. H.
AU - van Berge Henegouwen, M. I.
AU - van Duijvendijk, P.
AU - Wijnhoven, B. P. L.
AU - Stoot, J. H. M. B.
AU - Lacle, M.
AU - Ruurda, J. P.
AU - van Hillegersberg, R.
PY - 2019
Y1 - 2019
N2 - The standard of care for gastroesophageal cancer patients with hepatic or pulmonary metastases is best supportive care or palliative chemotherapy. Occasionally, patients can be selected for curative treatment instead. This study aimed to evaluate patients who underwent a resection of hepatic or pulmonary metastasis with curative intent. The Dutch national registry for histo- and cytopathology was used to identify these patients. Data were retrieved from the individual patient files. Kaplan-Meier survival analysis was performed. Between 1991 and 2016, 32,057 patients received a gastrectomy or esophagectomy for gastroesophageal cancer in the Netherlands. Of these patients, 34 selected patients received a resection of hepatic metastasis (n = 19) or pulmonary metastasis (n = 15) in 21 different hospitals. Only 4 patients received neoadjuvant therapy before metastasectomy. The majority of patients had solitary, metachronous metastases. After metastasectomy, grade 3 (Clavien-Dindo) complications occurred in 7 patients and mortality in 1 patient. After resection of hepatic metastases, the median potential follow-up time was 54 months. Median overall survival (OS) was 28 months and the 1-, 3-, and 5- year OS was 84%, 41%, and 31%, respectively. After pulmonary metastases resection, the median potential follow-up time was 80 months. The median OS was not reached and the 1-, 3-, and 5- year OS was 67%, 53%, and 53%, respectively. In selected patients with gastroesophageal cancer with hepatic or pulmonary metastases, metastasectomy was performed with limited morbidity and mortality and offered a 5-year OS of 31-53%. Further prospective studies are required.
AB - The standard of care for gastroesophageal cancer patients with hepatic or pulmonary metastases is best supportive care or palliative chemotherapy. Occasionally, patients can be selected for curative treatment instead. This study aimed to evaluate patients who underwent a resection of hepatic or pulmonary metastasis with curative intent. The Dutch national registry for histo- and cytopathology was used to identify these patients. Data were retrieved from the individual patient files. Kaplan-Meier survival analysis was performed. Between 1991 and 2016, 32,057 patients received a gastrectomy or esophagectomy for gastroesophageal cancer in the Netherlands. Of these patients, 34 selected patients received a resection of hepatic metastasis (n = 19) or pulmonary metastasis (n = 15) in 21 different hospitals. Only 4 patients received neoadjuvant therapy before metastasectomy. The majority of patients had solitary, metachronous metastases. After metastasectomy, grade 3 (Clavien-Dindo) complications occurred in 7 patients and mortality in 1 patient. After resection of hepatic metastases, the median potential follow-up time was 54 months. Median overall survival (OS) was 28 months and the 1-, 3-, and 5- year OS was 84%, 41%, and 31%, respectively. After pulmonary metastases resection, the median potential follow-up time was 80 months. The median OS was not reached and the 1-, 3-, and 5- year OS was 67%, 53%, and 53%, respectively. In selected patients with gastroesophageal cancer with hepatic or pulmonary metastases, metastasectomy was performed with limited morbidity and mortality and offered a 5-year OS of 31-53%. Further prospective studies are required.
KW - esophageal and gastric cancer
KW - esophageal and gastric surgery
KW - hepatic surgery
KW - metastasis
KW - pulmonary surgery
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85079036588&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31220859
UR - http://www.scopus.com/inward/record.url?scp=85079036588&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/dote/doz034
DO - https://doi.org/10.1093/dote/doz034
M3 - Article
C2 - 31220859
SN - 1120-8694
VL - 32
JO - Diseases of the Esophagus
JF - Diseases of the Esophagus
IS - 12
M1 - doz034
ER -