Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks

Simon Roh; Mark D Iannettoni; John Keech; Evgeny V Arshava; Anthony Swatek; Miriam B Zimmerman; Ronald J Weigel; Kalpaj R Parekh

doi:10.5090/kjtcs.2019.52.1.1

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Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks

Journal article

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Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks

Simon Roh, Mark D Iannettoni, John Keech, Evgeny V Arshava, Anthony Swatek, Miriam B Zimmerman, Ronald J Weigel and Kalpaj R Parekh

The Korean journal of thoracic and cardiovascular surgery, Vol.52(1), pp.1-8

02/2019

DOI: 10.5090/kjtcs.2019.52.1.1

PMCID: PMC6383855

PMID: 30834211

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Abstract

Neoadjuvant chemoradiation therapy (nCRT) has become the standard of care for esophageal cancer patients prior to esophagectomy. However, the optimal timing for surgery after completion of nCRT remains unclear. A retrospective review was performed of patients who underwent esophagectomy with cervical anastomosis for esophageal cancer at a single institution between January 2000 and June 2015. Patients were categorized into 3 cohorts: those who did not receive nCRT prior to esophagectomy (no nCRT), those who underwent esophagectomy within 35 days after nCRT (≤35d), and those who underwent esophagectomy more than 35 days after nCRT (>35d). A total of 366 esophagectomies were performed during the study period, and 348 patients met the inclusion criteria. Anastomotic leaks occurred in 11.8% of all patients included in the study (41 of 348). Within each cohort, anastomotic leaks were detected in 14.7% of patients (17 of 116) in the no nCRT cohort, 7.3% (13 of 177) in the ≤35d cohort, and 20.0% (11 of 55) in the >35d cohort (p=0.020). Significant differences in the occurrence of anastomotic leaks were observed between the no nCRT and ≤35d cohorts (p=0.044), and between the ≤35d and >35d cohorts (p=0.007). Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks.

Esophagectomy

Neoadjuvant therapy

Esophageal neoplasms

Anastomotic leak

Chemoradiotherapy

Details

Title: Subtitle: Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks
Creators: Simon Roh - Division of Interventional Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center
Mark D Iannettoni - Department of Cardiovasular Sciences, East Carolina University
John Keech - Department of Surgery, University of Iowa Hospitals and Clinics
Evgeny V Arshava - Department of Surgery, University of Iowa Hospitals and Clinics
Anthony Swatek - Department of Surgery, University of Iowa Hospitals and Clinics
Miriam B Zimmerman - Department of Biostatistics, University of Iowa College of Public Health
Ronald J Weigel - Department of Surgery, University of Iowa Hospitals and Clinics
Kalpaj R Parekh - Department of Surgery, University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: The Korean journal of thoracic and cardiovascular surgery, Vol.52(1), pp.1-8
DOI: 10.5090/kjtcs.2019.52.1.1
PMID: 30834211
PMCID: PMC6383855
NLM abbreviation: Korean J Thorac Cardiovasc Surg
ISSN: 2233-601X
eISSN: 2093-6516
Publisher: Korea (South)
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 02/2019
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Biostatistics; Surgery; Biochemistry and Molecular Biology; Cardiothoracic Surgery
Record Identifier: 9984051585602771

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