Dataset Information

Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients.

ABSTRACT:

Objective

The co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients.

Methods

Prospective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first beating-heart coronary artery bypass grafting (off-pump CABG) and then esophagectomy, were involved as group A. Then, 44 patients undergoing isolated esophagectomy were selected as group B using the propensity score matching method. Data including clinic pathological characteristics and postoperative outcomes were investigated. Kaplan-Meier analysis was used.

Results

The surgical procedure was performed through left lateral thoracotomy in all patients, except one patient in group A who received median sternotomy and left lateral thoracotomy. The operation time and blood loss were both more in group A, as a result of two operations performed at one session. Patients in both groups were followed up from 1.3 to 78.3 months. No significant between-group was found in overall survival or relapse-free survival.

Conclusion

The risk of simultaneous esophagectomy and cardiac surgery is not high. Despite certain differences in clinical indicators between groups, the safety of simultaneous procedures in group A is evident.

Trial registration

ChiCTR 1800014498 . Registered 17 January 2018.

SUBMITTER: Zhang W

PROVIDER: S-EPMC6201527 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients.

Zhang Weiran W Liu Ban B Zhou Yue Y Wang Feng F Gu Chang C Wang Qi Q Wang Xiaofang X Zhang Yangyang Y

World journal of surgical oncology 20181024 1

<h4>Objective</h4>The co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients.<h4>Methods</h4>Prospective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first ...[more]

PMID: 30355357

Similar Datasets

Project description:BACKGROUND: In primary esophageal cancer, studies have frequently focused on surgical patients in an effort to link outcome to hospital- or surgeon-related experience, with operative mortality used as the main outcome measure. Many studies have found an inverse relationship between operative mortality and hospital volume and surgical expertise. This study aims to assess the influence of surgeon-related expertise and hospital volume on the relative survival of operated esophageal cancer patients. METHODS: From January 1994 to January 2002, a total of 1149 consecutive patients with primary esophageal cancer were diagnosed in the region of the Comprehensive Cancer Center North-Netherlands. As a proxy for surgeon-related expertise, hospitals in this region were categorized into three types: university, teaching nonuniversity, and nonteaching hospitals. The influence of hospital type on the relative survival of operated patients was studied by a multivariate Poisson regression model. RESULTS: Of the 1149 patients, 18.5% underwent surgery. There was no evidence of selective referral for surgery between the three hospital types with regard to age, tumor stage, and location. For operated patients, the 5-year relative survival was 49.2% for the university hospital versus 32.6% and 27.3% for teaching nonuniversity and nonteaching hospitals, respectively (P = .0039). When adjusted for age, tumor stage, hospital volume and referral frequency, the relative excess risk of death for the university hospital was considerably lower at .57 (95% confidence interval, .29-1.12) compared with nonteaching hospitals and .43 (95% confidence interval, .24-.76) compared with teaching nonuniversity hospitals (P = .0126). CONCLUSIONS: In our region, patients with esophageal cancer who underwent esophagectomy in the university hospital had a markedly better relative survival compared with those who underwent surgery at teaching nonuniversity and nonteaching hospitals, emphasizing the need for referral of esophageal surgery to centers with a greater experience.

Dataset Information

Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients.

Objective

Methods

Results

Conclusion

Trial registration

Publications

Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients.

Similar Datasets

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