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The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer
It is uncertain whether coeliac node metastasis precludes long-term survival in distal oesophageal cancer. This nationwide population-based cohort study included patients who underwent surgical resection for stage III or IV distal oesophageal cancer in 1987–2010 with follow-up until 2014. A minority...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335647/ https://www.ncbi.nlm.nih.gov/pubmed/28256597 http://dx.doi.org/10.1038/srep43744 |
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author | Rutegård, Martin Lagergren, Pernilla Johar, Asif Rouvelas, Ioannis Lagergren, Jesper |
author_facet | Rutegård, Martin Lagergren, Pernilla Johar, Asif Rouvelas, Ioannis Lagergren, Jesper |
author_sort | Rutegård, Martin |
collection | PubMed |
description | It is uncertain whether coeliac node metastasis precludes long-term survival in distal oesophageal cancer. This nationwide population-based cohort study included patients who underwent surgical resection for stage III or IV distal oesophageal cancer in 1987–2010 with follow-up until 2014. A minority (17.0%) had neoadjuvant therapy. The prognosis in patients with coeliac node metastasis was compared with patients with no such metastasis and patients with more distant metastasis. Multivariable Cox proportional-hazards regression models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of disease-specific and overall mortality. Among 446 patients, 346 (77.6%) had no coeliac node metastasis, 56 (12.6%) had coeliac node metastasis, and 44 (9.9%) had more distant metastasis. Compared to coeliac node negative patients, coeliac node positive patients were at a 52% increased risk of disease-specific mortality (HR = 1.52, 95% CI 1.10–2.10), while patients with more distant metastasis had a 27% statistically non-significant increase (HR = 1.27, 95% CI 0.88–1.83). Patients with distant metastasis had no increase in disease-specific mortality compared to those with coeliac node metastasis (HR 0.71, 95% CI 0.40–1.27). Thus, patients with distal oesophageal cancer with coeliac node metastasis seem to have a similarly poor survival as patients with more distant metastasis, and thus may not benefit from surgery. |
format | Online Article Text |
id | pubmed-5335647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-53356472017-03-07 The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer Rutegård, Martin Lagergren, Pernilla Johar, Asif Rouvelas, Ioannis Lagergren, Jesper Sci Rep Article It is uncertain whether coeliac node metastasis precludes long-term survival in distal oesophageal cancer. This nationwide population-based cohort study included patients who underwent surgical resection for stage III or IV distal oesophageal cancer in 1987–2010 with follow-up until 2014. A minority (17.0%) had neoadjuvant therapy. The prognosis in patients with coeliac node metastasis was compared with patients with no such metastasis and patients with more distant metastasis. Multivariable Cox proportional-hazards regression models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of disease-specific and overall mortality. Among 446 patients, 346 (77.6%) had no coeliac node metastasis, 56 (12.6%) had coeliac node metastasis, and 44 (9.9%) had more distant metastasis. Compared to coeliac node negative patients, coeliac node positive patients were at a 52% increased risk of disease-specific mortality (HR = 1.52, 95% CI 1.10–2.10), while patients with more distant metastasis had a 27% statistically non-significant increase (HR = 1.27, 95% CI 0.88–1.83). Patients with distant metastasis had no increase in disease-specific mortality compared to those with coeliac node metastasis (HR 0.71, 95% CI 0.40–1.27). Thus, patients with distal oesophageal cancer with coeliac node metastasis seem to have a similarly poor survival as patients with more distant metastasis, and thus may not benefit from surgery. Nature Publishing Group 2017-03-03 /pmc/articles/PMC5335647/ /pubmed/28256597 http://dx.doi.org/10.1038/srep43744 Text en Copyright © 2017, The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Article Rutegård, Martin Lagergren, Pernilla Johar, Asif Rouvelas, Ioannis Lagergren, Jesper The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title | The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title_full | The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title_fullStr | The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title_full_unstemmed | The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title_short | The prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
title_sort | prognostic role of coeliac node metastasis after resection for distal oesophageal cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335647/ https://www.ncbi.nlm.nih.gov/pubmed/28256597 http://dx.doi.org/10.1038/srep43744 |
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