TY - JOUR
T1 - Trends in Distal Esophageal and Gastroesophageal Junction Cancer Care
T2 - The Dutch Nationwide Ivory Study
AU - Kalff, Marianne C.
AU - van Berge Henegouwen, Mark I.
AU - Baas, Peter C.
AU - Bahadoer, Renu R.
AU - Belt, Eric J.T.
AU - Brattinga, Baukje
AU - Claassen, Linda
AU - Ćosović, Admira
AU - Crull, David
AU - Daams, Freek
AU - van Dalsen, Annette D.
AU - Dekker, Jan Willem T.
AU - van Det, Marc J.
AU - Drost, Manon
AU - van Duijvendijk, Peter
AU - Eshuis, Wietse J.
AU - van Esser, Stijn
AU - Gaspersz, Marcia P.
AU - Görgec, Burak
AU - Groenendijk, Richard P.R.
AU - Hartgrink, Henk H.
AU - van der Harst, Erwin
AU - Haveman, Jan Willem
AU - Heisterkamp, Joos
AU - van Hillegersberg, Richard
AU - Kelder, Wendy
AU - Kingma, B. Feike
AU - Koemans, Willem J.
AU - Kouwenhoven, Ewout A.
AU - Lagarde, Sjoerd M.
AU - Lecot, Frederik
AU - van der Linden, Philip P.
AU - Luyer, Misha D.P.
AU - Nieuwenhuijzen, Grard A.P.
AU - Olthof, Pim B.
AU - van der Peet, Donald L.
AU - Pierie, Jean Pierre E.N.
AU - Pierik, E. G.J.M.Robert
AU - Plat, Victor D.
AU - Polat, Fatih
AU - Rosman, Camiel
AU - Ruurda, Jelle P.
AU - van Sandick, Johanna W.
AU - Scheer, Rene
AU - Slootmans, Cettela A.M.
AU - Sosef, Meindert N.
AU - Sosef, Odin V.
AU - de Steur, Wobbe O.
AU - Stockmann, Hein B.A.C.
AU - Stoop, Fanny J.
AU - Voeten, Daan M.
AU - Vugts, Guusje
AU - Vijgen, Guy H.E.J.
AU - Weeda, Víola B.
AU - Wiezer, Marinus J.
AU - Van Oijen, Martijn G.H.
AU - Gisbertz, Suzanne S.
N1 - Funding Information:
Luyer received research grants from Galvani and Medtronic. Nieuwenhuijzen reports consulting fees and research grants from Medtronic. Rosman has received research grants from Johnson&Johnson and Medtronic. van Berge Henegouwen reports research grants from Olympus and Stryker, in addition to consulting fees from Medtronic, Alesi Surgical, Johnson&Johnson and Mylan. van Oijen has received unrestricted research grants from Bayer, Lilly, Merck Serono, Nordic, Servier, and Roche. The remaining authors have no conflict of interest to report. No funding was received for this study.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Objective: This study evaluated the nationwide trends in care and accompanied postoperative outcomes for patients with distal esophageal and gastro-esophageal junction cancer.Summary of Background Data: The introduction of transthoracic esophagectomy, minimally invasive surgery, and neo-adjuvant chemo(radio)therapy changed care for patients with esophageal cancer.Methods: Patients after elective transthoracic and transhiatal esophagectomy for distal esophageal or gastroesophageal junction carcinoma in the Netherlands between 2007-2016 were included. The primary aim was to evaluate trends in both care and postoperative outcomes for the included patients. Additionally, postoperative outcomes after transthoracic and tran-shiatal esophagectomy were compared, stratified by time periods.Results: Among 4712 patients included, 74% had distal esophageal tumors and 87% had adenocarcinomas. Between 2007 and 2016, the proportion of transthoracic esophagectomy increased from 41% to 81%, and neo-adjuvant treatment and minimally invasive esophagectomy increased from 31% to 96%, and from 7% to 80%, respectively. Over this 10-year period, postoperative outcomes improved: postoperative morbidity decreased from 66.6% to 61.8% (P = 0.001), R0 resection rate increased from 90.0% to 96.5% (P <0.001), median lymph node harvest increased from 15 to 19 (P <0.001), and median survival increased from 35 to 41 months (P = 0.027).Conclusion: In this nationwide cohort, a transition towards more neo-adju-vant treatment, transthoracic esophagectomy and minimally invasive surgery was observed over a 10-year period, accompanied by decreased postoperative morbidity, improved surgical radicality and lymph node harvest, and improved survival.
AB - Objective: This study evaluated the nationwide trends in care and accompanied postoperative outcomes for patients with distal esophageal and gastro-esophageal junction cancer.Summary of Background Data: The introduction of transthoracic esophagectomy, minimally invasive surgery, and neo-adjuvant chemo(radio)therapy changed care for patients with esophageal cancer.Methods: Patients after elective transthoracic and transhiatal esophagectomy for distal esophageal or gastroesophageal junction carcinoma in the Netherlands between 2007-2016 were included. The primary aim was to evaluate trends in both care and postoperative outcomes for the included patients. Additionally, postoperative outcomes after transthoracic and tran-shiatal esophagectomy were compared, stratified by time periods.Results: Among 4712 patients included, 74% had distal esophageal tumors and 87% had adenocarcinomas. Between 2007 and 2016, the proportion of transthoracic esophagectomy increased from 41% to 81%, and neo-adjuvant treatment and minimally invasive esophagectomy increased from 31% to 96%, and from 7% to 80%, respectively. Over this 10-year period, postoperative outcomes improved: postoperative morbidity decreased from 66.6% to 61.8% (P = 0.001), R0 resection rate increased from 90.0% to 96.5% (P <0.001), median lymph node harvest increased from 15 to 19 (P <0.001), and median survival increased from 35 to 41 months (P = 0.027).Conclusion: In this nationwide cohort, a transition towards more neo-adju-vant treatment, transthoracic esophagectomy and minimally invasive surgery was observed over a 10-year period, accompanied by decreased postoperative morbidity, improved surgical radicality and lymph node harvest, and improved survival.
KW - complications
KW - esophageal cancer
KW - esophagectomy
KW - minimally invasive surgery
KW - neo-adjuvant treatment
KW - survival
U2 - 10.1097/SLA.0000000000005292
DO - 10.1097/SLA.0000000000005292
M3 - Article
C2 - 35129488
AN - SCOPUS:85140248011
SN - 0003-4932
VL - 277
SP - 619
EP - 628
JO - Annals of Surgery
JF - Annals of Surgery
IS - 4
ER -