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Surgical management...
Surgical management of esophageal sarcoma: a multicenter European experience
- Article/chapterEnglish2018
Publisher, publication year, extent ...
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2018-02-09
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Oxford University Press (OUP),2018
Numbers
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:137918005
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http://kipublications.ki.se/Default.aspx?queryparsed=id:137918005URI
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https://doi.org/10.1093/dote/dox146DOI
Supplementary language notes
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Language:English
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Summary in:English
Part of subdatabase
Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Esophageal sarcomas are rare and evidence in literature is scarce making their management difficult. The objective is to report surgical and oncological outcomes of esophageal sarcoma in a large multicenter European cohort. This is a retrospective multicenter study including all patients who underwent en-bloc esophagectomy for esophageal sarcoma in seven European tertiary referral centers between 1987 and 2016. The main outcomes and measures are pathological results, early and long-term outcomes. Among 10,936 esophageal resections for cancer, 21 (0.2%) patients with esophageal sarcoma were identified. The majority of tumors was located in the middle (n = 7) and distal (n = 9) third of the esophagus. Neoadjuvant chemoradiotherapy was performed in five patients. All the patients underwent en-bloc transthoracic esophagectomy (19 open, 2 minimally invasive). Postoperative mortality occurred in 1 patient (5%). One patient received adjuvant chemotherapy. Definitive pathological results were carcinosarcoma (n = 7), leiomyosarcoma (n = 5), and other types of sarcoma (n = 9). Microscopic R1 resection was present in one patient (5%) and seven patients (33%) had positive lymph nodes. Median follow-up was 16 (3–79) months in 20 of 21 patients (95%). One-, 3-, and 5-year overall survival rates were 74%, 43%, and 35%, respectively. One-, 3- and 5-years disease-free survival rates were 58%, 40%, and 33%, respectively. Median overall survival was 6 months in N+ patients vs. 37 months for N0 patients (p = 0.06). At the end of the follow-up period, nine patients had died from cancer recurrences (43%), three patients died from other reasons (14%), one patient was still alive with recurrence (5%) and the seven remaining patients were free of disease (33%). Recurrence was local (n = 3), metastatic (n = 3), or both (n = 4). In conclusion, carcinosarcoma and leiomyosarcoma were the most common esophageal sarcoma histological subtypes. Lymph node involvement was seen in one third of cases. A transthoracic en-bloc esophagectomy with radical lymphadenectomy should be the best surgical option to achieve complete resection. Long-term survival remained poor with a high local and distant recurrence rate.
Added entries (persons, corporate bodies, meetings, titles ...)
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Depypere, L
(author)
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Piessen, G
(author)
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Slaman, AE
(author)
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Wijnhoven, BPL
(author)
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Holscher, A
(author)
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Nilsson, MKarolinska Institutet
(author)
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Henegouwen, MIV
(author)
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van Lanschot, JJB
(author)
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Schroeder, W
(author)
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Thomas, PA
(author)
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Nafteux, P
(author)
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D'Journo, XB
(author)
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Karolinska Institutet
(creator_code:org_t)
Related titles
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In:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus: Oxford University Press (OUP)31:31442-2050
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In:Diseases of the Esophagus: Oxford University Press (OUP)31:31120-8694
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Mege, D
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Depypere, L
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Piessen, G
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Slaman, AE
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Wijnhoven, BPL
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Holscher, A
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Nilsson, M
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Henegouwen, MIV
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van Lanschot, JJ ...
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Schroeder, W
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Thomas, PA
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Nafteux, P
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D'Journo, XB
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Karolinska Institutet