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

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Author
Roh, Simon; Iannettoni, Mark D.; Keech, John; Arshava, Evgeny V.; Swatek, Anthony; Zimmerman, Miriam B.; Weigel, Ronald J.; Parekh, Kalpaj R.
Abstract
Background: 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. Methods: 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). Results: 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). Conclusion: Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks.
URI
http://hdl.handle.net/10342/8340
Subject
Esophageal neoplasms, Esophagectomy, Anastomotic leak, Chemoradiotherapy, Neoadjuvant therapy
Date
2019-02-05
Citation:
APA:
Roh, Simon, & Iannettoni, Mark D., & Keech, John, & Arshava, Evgeny V., & Swatek, Anthony, & Zimmerman, Miriam B., & Weigel, Ronald J., & Parekh, Kalpaj R.. (February 2019). Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks. Korean J Thorac Cardiovasc Surg, (52:1), p.1-8. Retrieved from http://hdl.handle.net/10342/8340

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MLA:
Roh, Simon, and Iannettoni, Mark D., and Keech, John, and Arshava, Evgeny V., and Swatek, Anthony, and Zimmerman, Miriam B., and Weigel, Ronald J., and Parekh, Kalpaj R.. "Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks". Korean J Thorac Cardiovasc Surg. 52:1. (1-8.), February 2019. October 22, 2020. http://hdl.handle.net/10342/8340.
Chicago:
Roh, Simon and Iannettoni, Mark D. and Keech, John and Arshava, Evgeny V. and Swatek, Anthony and Zimmerman, Miriam B. and Weigel, Ronald J. and Parekh, Kalpaj R., "Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks," Korean J Thorac Cardiovasc Surg 52, no. 1 (February 2019), http://hdl.handle.net/10342/8340 (accessed October 22, 2020).
AMA:
Roh, Simon, Iannettoni, Mark D., Keech, John, Arshava, Evgeny V., Swatek, Anthony, Zimmerman, Miriam B., Weigel, Ronald J., Parekh, Kalpaj R.. Timing of Esophagectomy after Neoadjuvant Chemoradiation Therapy Affects the Incidence of Anastomotic Leaks. Korean J Thorac Cardiovasc Surg. February 2019; 52(1) 1-8. http://hdl.handle.net/10342/8340. Accessed October 22, 2020.
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