• Annals of surgery · Nov 2022

    Recurrent Disease after Esophageal Cancer Surgery: A Substudy of The Dutch Nationwide Ivory Study.

    • Marianne C Kalff, Sofie P G Henckens, Daan M Voeten, David J Heineman, HulshofMaarten C C MMCCMDepartment of Radiotherapy, Amsterdam UMC, Amsterdam, The Netherlands., van LaarhovenHanneke W MHWMDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Wietse J Eshuis, Peter C Baas, Renu R Bahadoer, BeltEric J TEJTDepartment of Surgery, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands., Baukje Brattinga, Linda Claassen, Admira Ćosović, David Crull, Freek Daams, Annette D van Dalsen, DekkerJan Willem TJWTDepartment of Surgery, Reinier de Graaf Groep, Delft, The Netherlands., Marc J van Det, Manon Drost, Peter van Duijvendijk, Stijn van Esser, Marcia P Gaspersz, Burak Görgec, GroenendijkRichard P RRPRDepartment of Surgery, IJsselland Ziekenhuis, Capelle aan den IJssel, The Netherlands., Henk H Hartgrink, Erwin van der Harst, Jan W Haveman, Joos Heisterkamp, Richard van Hillegersberg, Wendy Kelder, B Feike Kingma, Willem J Koemans, Ewout A Kouwenhoven, Sjoerd M Lagarde, Frederik Lecot, Philip P van der Linden, LuyerMisha D PMDPDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands., NieuwenhuijzenGrard A PGAPDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands., Pim B Olthof, Donald L van der Peet, PierieJean-Pierre E NJENDepartment of Surgery, MC Leeuwarden, Leeuwarden, The Netherlands., PierikE G J M RobertEGJMRDepartment of Surgery, Isala Klinieken, Zwolle, The Netherlands., Victor D Plat, Fatih Polat, Camiel Rosman, Jelle P Ruurda, Johanna W van Sandick, Rene Scheer, Cettela A M Slootmans, Meindert N Sosef, Odin V Sosef, Wobbe O de Steur, StockmannHein B A CHBACDepartment of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands., Fanny J Stoop, Guusje Vugts, Guy H E J Vijgen, Víola B Weeda, Marinus J Wiezer, van OijenMartijn G HMGHDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Mark I van Berge Henegouwen, and Suzanne S Gisbertz.
    • Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
    • Ann. Surg. 2022 Nov 1; 276 (5): 806-813.

    ObjectiveThis study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery.BackgroundSurvival of recurrent esophageal cancer is usually poor, with limited prospects of remission.MethodsThis nationwide cohort study included patients with distal esophageal and gastroesophageal junction adenocarcinoma and squamous cell carcinoma after curatively intended esophagectomy in 2007 to 2016 (follow-up until January 2020). Patients with distant metastases detected during surgery were excluded. Univariable and multivariable logistic regression were used to identify predictors of recurrent disease. Multivariable Cox regression was used to determine the association of recurrence site and treatment intent with postrecurrence survival.ResultsAmong 4626 patients, 45.1% developed recurrent disease a median of 11 months postoperative, of whom most had solely distant metastases (59.8%). Disease recurrences were most frequently hepatic (26.2%) or pulmonary (25.1%). Factors significantly associated with disease recurrence included young age (≤65 y), male sex, adenocarcinoma, open surgery, transthoracic esophagectomy, nonradical resection, higher T-stage, and tumor positive lymph nodes. Overall, median postrecurrence survival was 4 months [95% confidence interval (95% CI): 3.6-4.4]. After curatively intended recurrence treatment, median survival was 20 months (95% CI: 16.4-23.7). Survival was more favorable after locoregional compared with distant recurrence (hazard ratio: 0.74, 95% CI: 0.65-0.84).ConclusionsThis study provides important prognostic information assisting in the surveillance and counseling of patients after curatively intended esophageal cancer surgery. Nearly half the patients developed recurrent disease, with limited prospects of survival. The risk of recurrence was higher in patients with a higher tumor stage, nonradical resection and positive lymph node harvest.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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