Recurrent Disease After Esophageal Cancer Surgery

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Recurrent Disease After Esophageal Cancer Surgery : A Substudy of The Dutch Nationwide Ivory Study. / Kalff, Marianne C.; Henckens, Sofie P. G.; Voeten, Daan M. et al.

In: Annals of surgery, Vol. 276, No. 5, 01.11.2022, p. 806-813.

Research output: Contribution to journal › Article › Academic › peer-review

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Kalff, MC , Henckens, SPG , Voeten, DM , Heineman, DJ , Hulshof, MCCM , van Laarhoven, HWM , Eshuis, WJ, Baas, PC, Bahadoer, RR, Belt, EJT, Brattinga, B, Claassen, L, Ćosović, A, Crull, D, Daams, F, van Dalsen, AD, Dekker, JWT, van Det, MJ, Drost, M, van Duijvendijk, P , van Esser, S, Gaspersz, MP, Görgec, B, Groenendijk, RPR, Hartgrink, HH, van der Harst, E, Haveman, JW, Heisterkamp, J, van Hillegersberg, R, Kelder, W, Kingma, BF, Koemans, WJ, Kouwenhoven, EA, Lagarde, SM, Lecot, F, van der Linden, PP, Luyer, MDP, Nieuwenhuijzen, GAP, Olthof, PB , van der Peet, DL, Pierie, J-PEN, Pierik, EGJMR, Plat, VD, Polat, F, Rosman, C, Ruurda, JP , van Sandick, JW, Scheer, R, Slootmans, CAM, Sosef, MN, Sosef, OV, de Steur, WO, Stockmann, HBAC, Stoop, FJ, Vugts, G, Vijgen, GHEJ, Weeda, VOB, Wiezer, MJ, van Oijen, MGH , van Berge Henegouwen, MI & Gisbertz, SS 2022, 'Recurrent Disease After Esophageal Cancer Surgery: A Substudy of The Dutch Nationwide Ivory Study', Annals of surgery, vol. 276, no. 5, pp. 806-813. https://doi.org/10.1097/SLA.0000000000005638

BibTeX

@article{5af08c8b96d14938b9819bacd7e68929,

title = "Recurrent Disease After Esophageal Cancer Surgery: A Substudy of The Dutch Nationwide Ivory Study",

abstract = "OBJECTIVE: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery. BACKGROUND: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission. METHODS: This 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. RESULTS: Among 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). CONCLUSIONS: This 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.",

keywords = "Esophageal cancer, Esophagectomy, Neoadjuvant treatment, Palliative treatment, Recurrences",

author = "Kalff, {Marianne C.} and Henckens, {Sofie P. G.} and Voeten, {Daan M.} and Heineman, {David J.} and Hulshof, {Maarten C. C. M.} and {van Laarhoven}, {Hanneke W. M.} and Eshuis, {Wietse J.} and Baas, {Peter C.} and Bahadoer, {Renu R.} and Belt, {Eric J. T.} and Baukje Brattinga and Linda Claassen and Admira {\'C}osovi{\'c} and David Crull and Freek Daams and {van Dalsen}, {Annette D.} and Dekker, {Jan Willem T.} and {van Det}, {Marc J.} and Manon Drost and {van Duijvendijk}, Peter and {van Esser}, Stijn and Gaspersz, {Marcia P.} and Burak G{\"o}rgec and Groenendijk, {Richard P. R.} and Hartgrink, {Henk H.} and {van der Harst}, Erwin and Haveman, {Jan W.} and Joos Heisterkamp and {van Hillegersberg}, Richard and Wendy Kelder and Kingma, {B. Feike} and Koemans, {Willem J.} and Kouwenhoven, {Ewout A.} and Lagarde, {Sjoerd M.} and Frederik Lecot and {van der Linden}, {Philip P.} and Luyer, {Misha D. P.} and Nieuwenhuijzen, {Grard A. P.} and Olthof, {Pim B.} and {van der Peet}, {Donald L.} and Pierie, {Jean-Pierre E. N.} and Pierik, {E. G. J. M. Robert} and Plat, {Victor D.} and Fatih Polat and Camiel Rosman and Ruurda, {Jelle P.} and {van Sandick}, {Johanna W.} and Rene Scheer and Slootmans, {Cettela A. M.} and Sosef, {Meindert N.} and Sosef, {Odin V.} and {de Steur}, {Wobbe O.} and Stockmann, {Hein B. A. C.} and Stoop, {Fanny J.} and Guusje Vugts and Vijgen, {Guy H. E. J.} and Weeda, {V. ola B.} and Wiezer, {Marinus J.} and {van Oijen}, {Martijn G. H.} and {van Berge Henegouwen}, {Mark I.} and Gisbertz, {Suzanne S.}",

year = "2022",

month = nov,

day = "1",

doi = "10.1097/SLA.0000000000005638",

language = "English",

volume = "276",

pages = "806--813",

journal = "Annals of surgery",

issn = "0003-4932",

publisher = "Lippincott Williams and Wilkins",

number = "5",

}

RIS

TY - JOUR

T1 - Recurrent Disease After Esophageal Cancer Surgery

T2 - A Substudy of The Dutch Nationwide Ivory Study

AU - Kalff, Marianne C.

AU - Henckens, Sofie P. G.

AU - Voeten, Daan M.

AU - Heineman, David J.

AU - Hulshof, Maarten C. C. M.

AU - van Laarhoven, Hanneke W. M.

AU - Eshuis, Wietse J.

AU - Baas, Peter C.

AU - Bahadoer, Renu R.

AU - Belt, Eric J. T.

AU - Brattinga, Baukje

AU - Claassen, Linda

AU - Ćosović, Admira

AU - Crull, David

AU - Daams, Freek

AU - van Dalsen, Annette D.

AU - Dekker, Jan Willem T.

AU - van Det, Marc J.

AU - Drost, Manon

AU - van Duijvendijk, Peter

AU - van Esser, Stijn

AU - Gaspersz, Marcia P.

AU - Görgec, Burak

AU - Groenendijk, Richard P. R.

AU - Hartgrink, Henk H.

AU - van der Harst, Erwin

AU - Haveman, Jan W.

AU - Heisterkamp, Joos

AU - van Hillegersberg, Richard

AU - Kelder, Wendy

AU - Kingma, B. Feike

AU - Koemans, Willem J.

AU - Kouwenhoven, Ewout A.

AU - Lagarde, Sjoerd M.

AU - Lecot, Frederik

AU - van der Linden, Philip P.

AU - Luyer, Misha D. P.

AU - Nieuwenhuijzen, Grard A. P.

AU - Olthof, Pim B.

AU - van der Peet, Donald L.

AU - Pierie, Jean-Pierre E. N.

AU - Pierik, E. G. J. M. Robert

AU - Plat, Victor D.

AU - Polat, Fatih

AU - Rosman, Camiel

AU - Ruurda, Jelle P.

AU - van Sandick, Johanna W.

AU - Scheer, Rene

AU - Slootmans, Cettela A. M.

AU - Sosef, Meindert N.

AU - Sosef, Odin V.

AU - de Steur, Wobbe O.

AU - Stockmann, Hein B. A. C.

AU - Stoop, Fanny J.

AU - Vugts, Guusje

AU - Vijgen, Guy H. E. J.

AU - Weeda, V. ola B.

AU - Wiezer, Marinus J.

AU - van Oijen, Martijn G. H.

AU - van Berge Henegouwen, Mark I.

AU - Gisbertz, Suzanne S.

PY - 2022/11/1

Y1 - 2022/11/1

N2 - OBJECTIVE: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery. BACKGROUND: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission. METHODS: This 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. RESULTS: Among 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). CONCLUSIONS: This 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.

AB - OBJECTIVE: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery. BACKGROUND: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission. METHODS: This 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. RESULTS: Among 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). CONCLUSIONS: This 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.

KW - Esophageal cancer

KW - Esophagectomy

KW - Neoadjuvant treatment

KW - Palliative treatment

KW - Recurrences

UR - http://www.scopus.com/inward/record.url?scp=85139571115&partnerID=8YFLogxK

U2 - 10.1097/SLA.0000000000005638

DO - 10.1097/SLA.0000000000005638

M3 - Article

C2 - 35880759

VL - 276

SP - 806

EP - 813

JO - Annals of surgery

JF - Annals of surgery

SN - 0003-4932

IS - 5

ER -

ID: 26494927

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