Details

Autor(en) / Beteiligte

• Junttila, Anna
• Helminen, Olli
• Helmiö, Mika
• Huhta, Heikki
• Kallio, Raija
• Koivukangas, Vesa
• Kokkola, Arto
• Laine, Simo
• Lietzen, Elina
• Meriläinen, Sanna
• Pohjanen, Vesa-Matti
• Rantanen, Tuomo
• Ristimäki, Ari
• Räsänen, Jari V
• Saarnio, Juha
• Sihvo, Eero
• Toikkanen, Vesa
• Tyrväinen, Tuula
• Valtola, Antti
• Kauppila, Joonas H

Titel

Five-year Survival after McKeown Compared to Ivor-Lewis Esophagectomy for Esophageal Cancer: A Population-based Nationwide Study in Finland

Ist Teil von

• Annals of surgery, 2023-06, Vol.277 (6), p.964-970

Ort / Verlag

United States

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• The aim of study was to compare overall 5-year survival of esophageal cancer patients undergoing transthoracic esophagectomy with either neck or intrathoracic anastomosis, that is, McKeown and Ivor-Lewis esophagectomy. No national studies comparing long-term survival after McKeown and ivor-Lewis esophagectomies in the West exist. This population-based nationwide study included all curatively intended transthoracic esophagectomies for esophageal adenocarcinoma or squamous cell carcinoma in Finland in 1987 to 2016, with follow-up until December 31, 2019. Cox proportional hazard models provided hazard ratios (HR) with 95% confidence intervals (ci) of all-cause 5-year mortality. The results were adjusted for age, sex, year of the operation, comorbidities, histology, stage, and neoadjuvant treatment. Adjusted model 2 included also tumor location and lymph node yield. A total of 990 patients underwent McKeown (n = 278) or Ivor-Lewis (n = 712) esophagectomy The observed overall 5-year survival was 43.1% after McKeown, and 45.9% after Ivor-Lewis esophagectomy. McKeown esophagectomy was not associated with the overall 5-year mortality (adjusted HR 1.11, 95% CI: 0.89-1.38), compared to Ivor-Lewis esophagectomy. Additional adjustment for tumor location and lymphadenectomy further attenuated the point estimate (HR 1.06, 95% CI: 0.85-1.33). Surgical approach was not associated with 90-day mortality rate (adjusted HR 1.15, 95% CI: 0.67-1.97). This population-based nationwide study suggests that overall 5-year survival or 90-day survival with McKeown and Ivor-Lewis esopha-gectomy for esophageal cancer are comparable.