SwePub
Sök i LIBRIS databas

  Utökad sökning

(WFRF:(Lagergren Jesper))
 

Sökning: (WFRF:(Lagergren Jesper)) > Extent of Lymphaden...

  • Gottlieb-Vedi, EivindKarolinska Institutet (författare)

Extent of Lymphadenectomy and Long-Term Survival in Esophageal Cancer

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • Wolters Kluwer,2023
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-460819
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-460819URI
  • https://doi.org/10.1097/SLA.0000000000005028DOI
  • https://lup.lub.lu.se/record/bca605e0-6a2e-454a-b63d-f5370f01b59aURI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-179522URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152050709URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding: Swedish Research Council [201900209]; Swedish Cancer Society [180684]
  • Objective: To examine the hypothesis that survival in esophageal cancer increases with more removed lymph nodes during esophagectomy up to a plateau, after which it levels out or even decreases with further lymphadenectomy.Summary of Background Data: There is uncertainty regarding the ideal extent of lymphadenectomy during esophagectomy to optimize long-term survival in esophageal cancer.Methods: This population-based cohort study included almost every patient who underwent esophagectomy for esophageal cancer in Sweden or Finland in 2000-2016 with follow-up through 2019. Degree of lymphadenectomy, divided into deciles, was analyzed in relation to all-cause 5-year mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (95% CI) adjusted for all established prognostic factors.Results: Among 2,306 patients, the 2nd (4-8 nodes), 7th (21-24 nodes) and 8th decile (25-30 nodes) of lymphadenectomy showed the lowest all-cause 5-year mortality compared to the 1st decile (HR = 0.77, 95% CI 0.61-0.97, HR = 0.76, 95% CI 0.59-0.99, and HR = 0.73, 95% CI 0.57-0.93, respectively). In stratified analyses, the survival benefit was greatest in decile 7 for patients with pathological T-stage T3/T4 (HR = 0.56, 95% CI 0.40-0.78), although it was statistically improved in all deciles except decile 10. For patients without neoadjuvant chemotherapy, survival was greatest in decile 7 (HR = 0.60, 95% CI 0.41-0.86), although survival was also statistically significantly improved in deciles 2, 6, and 8.Conclusion: Survival in esophageal cancer was not improved by extensive lymphadenectomy, but resection of a moderate number (20-30) of nodes was prognostically beneficial for patients with advanced T-stages (T3/T4) and those not receiving neoadjuvant therapy.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Kauppila, Joonas HKarolinska Institutet (författare)
  • Mattsson, FredrikKarolinska Institute,Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden(Swepub:lu)fr3821ma (författare)
  • Hedberg, Jakob,1972-Uppsala University,Uppsala universitet,Institutionen för kirurgiska vetenskaper,Department of Surgical Sciences, Uppsala University, Sweden(Swepub:uu)jakhe890 (författare)
  • Johansson, JanKarolinska Institutet,Lund University,Lunds universitet,Upper Gastrointestinal Surgery,Forskargrupper vid Lunds universitet,Lund University Research Groups,Department of Surgery, Skåne University Hospital, Lund; Faculty of Medicine, Clinical Sciences, Lund University, Sweden(Swepub:lu)kir-jjo (författare)
  • Edholm, DavidLinköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)daved38 (författare)
  • Lagergren, PernillaKarolinska Institutet (författare)
  • Nilsson, MagnusKarolinska Institutet (författare)
  • Lagergren, JesperUpper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; School of Cancer and Pharmaceutical Sciences, King's College London, and Guy's and St Thomas’ NHS Foundation Trust, London, UK. (författare)
  • Karolinska InstituteKarolinska Institutet (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Annals of Surgery: Wolters Kluwer277:3, s. 429-4360003-49321528-1140

Internetlänk

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy