Evaluation of the Effect of Esophagectomy and Non-Surgical Surgical on the Survival Rate of Patients with Esophageal Cancer
DOI:
https://doi.org/10.22100/jkh.v19i1.2764Keywords:
Survival, General surgery, Esophageal neoplasms,, MortalityAbstract
Introduction: The aim of this study was to evaluate the survival rate and complications and compare surgical and non-surgical treatment methods in esophageal cancer patients referred to Baqiyatallah Hospital in Tehran.
Methods: In this retrospective cohort study, 96 patients with esophageal cancer between 2011 and 2016 were included using census sampling. The patients were categorized into esophagectomy and non-surgical treatment groups. The data was analyzed using SPSS 24 software, employing descriptive methods and the Chi-square test for analysis.
Results: Among 96 patients with esophageal cancer, 58 (60.4%) were male and 38 (39.4%) were female. Among all patients, 37 (38.5%) underwent esophagectomy surgery while 59 (61.5%) received non-surgical treatment. The highest incidence of tumors was found in the lower 1/3 of the esophagus, affecting 47 patients (48.95%). The most frequent post-surgery complication was minor, occurring in 14 patients (37.8%). In the surgical group, the average survival time was 28.1 months, whereas in the non-surgical group, it was 13.1 months on average. When comparing survival rates, a significant difference was observed between the one-year and three-year survival periods in both the surgical and non-surgical groups.
Conclusion: The results indicate that esophageal cancer patients who underwent esophagectomy had longer survival times compared to those receiving other treatments, with fewer complications and lower mortality rates. The low incidence of complications following esophagectomy at the Baqiyatallah treatment center reflects the center's effective approach to treatment procedures.
References
Pakzad R, Mohammadian-Hafshejani A, Khosravi B, Soltani S, Pakzad I, Mohammadian M, et al. The incidence and mortality of esophageal cancer and their relationship to development in Asia. Ann Transl Med 2016;4. doi: 10.1016/j.prnil.2015.09.001
Booka E, Takeuchi H, Nishi T, Matsuda S, Kaburagi T, Fukuda K, et al. The impact of postoperative complications on survivals after esophagectomy for esophageal cancer. Medicine 2015;94. doi: 10.1097/MD.0000000000001369
Sihag S, Kosinski AS, Gaissert HA, Wright CD, Schipper PH. Minimally invasive versus open esophagectomy for esophageal cancer: a comparison of early surgical outcomes from the Society of Thoracic Surgeons National Database. Ann Thorac Surg 2016;101:1281-9. doi: 10.1016/j.athoracsur.2015.09.095
Wright CD, Kucharczuk JC, O'Brien SM, Grab JD, Allen MS. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model. J Thorac Cardiovasc Surg 2009;137:587-96. doi: 10.1016/j.jtcvs.2008.11.042
Nikfarjam Z, Massoudi T, Salehi M, Salehi M, Khoshroo F. Demographic survey of four thousand patients with 10 common cancers in North Eastern Iran over the past three decades. Asian Pac J Cancer Prev 2015;15:10193-8. doi: 10.7314/APJCP.2014.15.23.10193
Brunicardi FC. Schwartz's principles of surgery: Mc Graw Hill; 2015.
Bartels H, Stein H, Siewert J. Preoperative risk analysis and postoperative mortality of oesophagectomy for resectable oesophageal cancer. Br J Surg 1998;85:840-4. doi: 10.1046/j.1365-2168.1998.00663.x
Guttmann DM, Mitra N, Metz JM, Plastaras J, Feng W, Swisher-McClure S. Neoadjuvant chemoradiation is associated with improved overall survival in older patients with esophageal cancer. J Geriatr Oncol 2018;9:40-6. doi: 10.1016/j.jgo.2017.08.010
Kjaer DW, Fjerderholt KT, Kirkegaard J, Okholm C, Achiam MP, Svendsen LB, et al. High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma. Journal of Surgery 2018;6:1-7. doi: 10.11648/j.js.20180601.11
Nederlof N, Slaman AE, van Hagen P, van der Gaast A, Slankamenac K, Gisbertz SS, et al. Using the comprehensive complication index to assess the impact of neoadjuvant chemoradiotherapy on complication severity after esophagectomy for cancer. Ann Surg Oncol 2016;23:3964-71. doi: 10.1245/s10434-016-5291-3
Zingg U, Smithers BM, Gotley DC, Smith G, Aly A, Clough A, et al. Factors associated with postoperative pulmonary morbidity after esophagectomy for cancer. Ann Surg Oncol 2011;18:1460-8. doi: 10.1245/s10434-010-1474-5
Harirchi I, Kolahdoozan S, Hajizadeh S, Safari F, Sedighi Z, Nahvijou A, et al. Esophageal cancer in Iran; a population-based study regarding adequacy of cancer surgery and overall survival. Eur J Surg Oncol 2014;40:352-7. doi: 10.1016/j.ejso.2013.10.011
Maas K, Cuesta M, van Berge Henegouwen M, Roig J, Bonavina L, Rosman C, et al. Quality of life and late complications after minimally invasive compared to open esophagectomy: results of a randomized trial. World J Surg 2015;39:1986-93. doi: 10.1007/s00268-015-3100-y
Uchihara T, Yoshida N, Baba Y, Yagi T, Toihata T, Oda E, et al. Risk factors for pulmonary morbidities after minimally invasive esophagectomy for esophageal cancer. Surg Endosc 2018;32:2852-8. doi: 10.1007/s00464-017-5993-z
Yamamoto S, Ishihara R, Motoori M, Kawaguchi Y, Uedo N, Takeuchi Y, et al. Comparison between definitive chemoradiotherapy and esophagectomy in patients with clinical stage I esophageal squamous cell carcinoma. Am J Gastroenterol 2011;106:1048-54. doi: 10.1038/ajg.2011.42
Qin J, Peng Y, Chen W, Ma H, Zheng Y, Li Y, et al. Comparative study of esophagectomy, endoscopic therapy, and radiotherapy for cT1N0M0 esophageal cancer in elderly patients: A SEER database analysis. Thorac Cancer 2019;10:1511-20. doi: 10.1111/1759-7714.13080
Walther C, Zilling T, Perfekt R, Möller T. Strongly increasing incidence of adenocarcinoma of the esophagus and gastric cardia. Lakartidningen 2004;101:180-3. doi:
Ohtsu A. Chemoradiotherapy for esophageal cancer: current status and perspectives. Int J Clin Oncol 2004;9:444-50. doi: 10.1007/s10147-004-0454-9
Walsh TN, Noonan N, Hollywood D, Kelly A, Keeling N, Hennessy TP. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med 1996;335:462-7. doi: 10.1056/NEJM199608153350702
Chen M-F, Chen P-T, Lu M-S, Lee C-P, Chen W-C. Survival benefit of surgery to patients with esophageal squamous cell carcinoma. Sci Rep 2017;7:1-9. doi: 10.1038/srep46139
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.