Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer

Objective: The objectives of this study were to establish if R1 resection margin after esophagectomy was (i) a poor prognostic factor independent of patient and tumor characteristics, (ii) a marker of tumor aggressiveness and (iii) to look at the impact of adjuvant treatment in this subpopulation. M...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Markar, Sheraz R. (author)
مؤلفون آخرون: Gronnier, Caroline (author), Duhamel, Alain (author), Pasquer, Arnaud (author), Théreaux, Jérémie (author), Du Rieu, Mael Chalret (author), Lefevre, Jérémie H. (author), Turner, Kathleen (author), Luc, Guillaume (author), Mariette, Christophe (author)
التنسيق: article
منشور في: 2016
الوصول للمادة أونلاين:http://hdl.handle.net/10725/14209
https://doi.org/10.1097/SLA.0000000000001325
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://pubmed.ncbi.nlm.nih.gov/26135681/
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author Markar, Sheraz R.
author2 Gronnier, Caroline
Duhamel, Alain
Pasquer, Arnaud
Théreaux, Jérémie
Du Rieu, Mael Chalret
Lefevre, Jérémie H.
Turner, Kathleen
Luc, Guillaume
Mariette, Christophe
author2_role author
author
author
author
author
author
author
author
author
author_facet Markar, Sheraz R.
Gronnier, Caroline
Duhamel, Alain
Pasquer, Arnaud
Théreaux, Jérémie
Du Rieu, Mael Chalret
Lefevre, Jérémie H.
Turner, Kathleen
Luc, Guillaume
Mariette, Christophe
author_role author
dc.contributor.none.fl_str_mv Chemaly, Rodrigue
dc.creator.none.fl_str_mv Markar, Sheraz R.
Gronnier, Caroline
Duhamel, Alain
Pasquer, Arnaud
Théreaux, Jérémie
Du Rieu, Mael Chalret
Lefevre, Jérémie H.
Turner, Kathleen
Luc, Guillaume
Mariette, Christophe
dc.date.none.fl_str_mv 2016
2022-11-03T09:34:27Z
2022-11-03T09:34:27Z
2022-11-03
dc.identifier.none.fl_str_mv 0003-4932
http://hdl.handle.net/10725/14209
https://doi.org/10.1097/SLA.0000000000001325
Markar, S. R., Gronnier, C., Duhamel, A., Pasquer, A., Théreaux, J., Rieu, M. C. D., ... & Mariette, C. (2016). Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer. Annals of surgery, 263(4), 712-718.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://pubmed.ncbi.nlm.nih.gov/26135681/
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Annals of Surgery
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Objective: The objectives of this study were to establish if R1 resection margin after esophagectomy was (i) a poor prognostic factor independent of patient and tumor characteristics, (ii) a marker of tumor aggressiveness and (iii) to look at the impact of adjuvant treatment in this subpopulation. Methods: Data were collected from 30 European centers from 2000 to 2010. Patients with an R1 resection margin (n = 242) were compared with those with an R0 margin (n = 2573) in terms of short- and long-term outcomes. Propensity score matching and multivariable analyses were used to compensate for differences in baseline characteristics. Results: Independent factors significantly associated with an R1 resection margin included an upper third esophageal tumor location, preoperative malnutrition, and pathological stage III. There were significant differences between the groups in postoperative histology, with an increase in pathological stage III and TRG 4–5 in the R1 group. Total average lymph node harvests were similar between the groups; however, there was an increase in the number of positive lymph nodes seen in the R1 group. Propensity matched analysis confirmed that R1 resection margin was significantly associated with reduced overall survival and increased overall, locoregional, and mixed tumor recurrence. Similar observations were seen in the subgroup that received neoadjuvant chemoradiation. In R1 patients adjuvant therapy improved survival and reduced distant recurrence however failed to affect locoregional recurrence. Conclusions: This large multicenter European study provides evidence to support the notion that R1 resection margin is a prognostic indication of aggressive tumor biology with a poor long-term prognosis.
eu_rights_str_mv openAccess
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id LAURepo_eddffeb4dd355f763bbdc8563c20d283
identifier_str_mv 0003-4932
Markar, S. R., Gronnier, C., Duhamel, A., Pasquer, A., Théreaux, J., Rieu, M. C. D., ... & Mariette, C. (2016). Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer. Annals of surgery, 263(4), 712-718.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/14209
publishDate 2016
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spelling Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancerMarkar, Sheraz R.Gronnier, CarolineDuhamel, AlainPasquer, ArnaudThéreaux, JérémieDu Rieu, Mael ChalretLefevre, Jérémie H.Turner, KathleenLuc, GuillaumeMariette, ChristopheObjective: The objectives of this study were to establish if R1 resection margin after esophagectomy was (i) a poor prognostic factor independent of patient and tumor characteristics, (ii) a marker of tumor aggressiveness and (iii) to look at the impact of adjuvant treatment in this subpopulation. Methods: Data were collected from 30 European centers from 2000 to 2010. Patients with an R1 resection margin (n = 242) were compared with those with an R0 margin (n = 2573) in terms of short- and long-term outcomes. Propensity score matching and multivariable analyses were used to compensate for differences in baseline characteristics. Results: Independent factors significantly associated with an R1 resection margin included an upper third esophageal tumor location, preoperative malnutrition, and pathological stage III. There were significant differences between the groups in postoperative histology, with an increase in pathological stage III and TRG 4–5 in the R1 group. Total average lymph node harvests were similar between the groups; however, there was an increase in the number of positive lymph nodes seen in the R1 group. Propensity matched analysis confirmed that R1 resection margin was significantly associated with reduced overall survival and increased overall, locoregional, and mixed tumor recurrence. Similar observations were seen in the subgroup that received neoadjuvant chemoradiation. In R1 patients adjuvant therapy improved survival and reduced distant recurrence however failed to affect locoregional recurrence. Conclusions: This large multicenter European study provides evidence to support the notion that R1 resection margin is a prognostic indication of aggressive tumor biology with a poor long-term prognosis.PublishedChemaly, Rodrigue2022-11-03T09:34:27Z2022-11-03T09:34:27Z20162022-11-03Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0003-4932http://hdl.handle.net/10725/14209https://doi.org/10.1097/SLA.0000000000001325Markar, S. R., Gronnier, C., Duhamel, A., Pasquer, A., Théreaux, J., Rieu, M. C. D., ... & Mariette, C. (2016). Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer. Annals of surgery, 263(4), 712-718.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://pubmed.ncbi.nlm.nih.gov/26135681/enAnnals of Surgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/142092022-11-03T14:49:31Z
spellingShingle Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
Markar, Sheraz R.
status_str publishedVersion
title Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
title_full Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
title_fullStr Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
title_full_unstemmed Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
title_short Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
title_sort Significance of microscopically incomplete resection margin after esophagectomy for esophageal cancer
url http://hdl.handle.net/10725/14209
https://doi.org/10.1097/SLA.0000000000001325
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://pubmed.ncbi.nlm.nih.gov/26135681/