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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005670naa a2200577 4500
001oai:DiVA.org:uu-460819
003SwePub
008211209s2023 | |||||||||||000 ||eng|
009oai:lup.lub.lu.se:bca605e0-6a2e-454a-b63d-f5370f01b59a
009oai:DiVA.org:liu-179522
009oai:prod.swepub.kib.ki.se:152050709
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4608192 URI
0247 a https://doi.org/10.1097/SLA.00000000000050282 DOI
0247 a https://lup.lub.lu.se/record/bca605e0-6a2e-454a-b63d-f5370f01b59a2 URI
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-1795222 URI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1520507092 URI
040 a (SwePub)uud (SwePub)lud (SwePub)liud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Gottlieb-Vedi, Eivindu Karolinska Institutet4 aut
2451 0a Extent of Lymphadenectomy and Long-Term Survival in Esophageal Cancer
264 1b Wolters Kluwer,c 2023
338 a print2 rdacarrier
500 a Funding: Swedish Research Council [201900209]; Swedish Cancer Society [180684]
520 a 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.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
653 a esophageal cancer
653 a esophagectomy
653 a lymph node
653 a lymphadenectomy
653 a surgery
653 a survival
7001 a Kauppila, Joonas Hu Karolinska Institutet4 aut
7001 a Mattsson, Fredriku Karolinska Institute,Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden4 aut0 (Swepub:lu)fr3821ma
7001 a Hedberg, Jakob,d 1972-u Uppsala University,Uppsala universitet,Institutionen för kirurgiska vetenskaper,Department of Surgical Sciences, Uppsala University, Sweden4 aut0 (Swepub:uu)jakhe890
7001 a Johansson, Janu Karolinska Institutet,Lund University,Lunds universitet,Upper Gastrointestinal Surgery,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Department of Surgery, Skåne University Hospital, Lund; Faculty of Medicine, Clinical Sciences, Lund University, Sweden4 aut0 (Swepub:lu)kir-jjo
7001 a Edholm, Davidu Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US4 aut0 (Swepub:liu)daved38
7001 a Lagergren, Pernillau Karolinska Institutet4 aut
7001 a Nilsson, Magnusu Karolinska Institutet4 aut
7001 a Lagergren, Jesperu Upper 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.4 aut
7102 a Karolinska Instituteb Karolinska Institutet4 org
7730 t Annals of Surgeryd : Wolters Kluwerg 277:3, s. 429-436q 277:3<429-436x 0003-4932x 1528-1140
8564 u http://dx.doi.org/10.1097/SLA.0000000000005028y FULLTEXT
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-460819
8564 8u https://doi.org/10.1097/SLA.0000000000005028
8564 8u https://lup.lub.lu.se/record/bca605e0-6a2e-454a-b63d-f5370f01b59a
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-179522
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:152050709

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