OBJECTIVE: Very few studies have examined post-operative morbidity after resection of @entity189 , especially in @entity1 treated with induction chemo- and radiotherapy for locally advanced stages. This study assessed the effects of induction chemoradiotherapy on post-operative course after resection of locally advanced @entity189 ( @entity15004 + cM1lymph). METHODS: Induction therapy consisted of @entity1487 days 1-5 and days 21-25, @entity900 day 1 + day 21 and concomitant radiotherapy 18-20 fractions of 2Gy (total dose 36-40Gy). Induction chemoradiotherapy was completed in 109 @entity1 . Surgery was performed in 90 @entity1 (operability: 90/109 = 83%): 85 @entity1 underwent resection with curative intent (resectability: 85/109 = 78%), bypass operation was performed in five @entity1 . Nineteen @entity1 could not be operated on. Results were compared to a matched group of pT3M1LYM/pT4 @entity1 (n = 86) who underwent primary surgery in the same period. RESULTS: Resection was complete (R0) in 68 @entity1 (68/90 = 76%). Mean duration of surgery was 428 min (range: 240-690). Peroperative complications were @entity548 in three @entity1 (3/90 = 3.3%), tracheobronchial perforation in three @entity1 (3/90 = 3.3%). Median total hospital stay was 20.5 days (range: 8-355). Mean duration of intubation was 7 days (range: 1-190); 67 @entity1 (67/90 = 74.4%) were intubated for less than 24 h. @entity5 related hospital mortality after resection was 8.3% (7/84 @entity1 ). Mortality after two-field lymphadenectomy was 5.2 versus 11.7% after three-field lymphadenectomy. After primary surgery (n = 86) overall mortality was 2.3% (P = 0.015) and nil after two- and three-field lymphadenectomy (P = 0.011). Medical morbidity consisted of @entity55 in 43 @entity1 (43/90 = 48%), @entity891 in ten @entity1 (10/90 = 11%), @entity943 in 21 @entity1 (21/90 = 23%), @entity295 in 11 @entity1 (11/90 = 12%) and adult @entity649 in ten @entity1 (10/90 = 11%). Surgical morbidity included @entity1143 in 16 @entity1 (16/90 = 18%), @entity292 in two @entity1 (2/90 = 2%), chylothorax in two @entity1 (2/90 = 2%) and acute @entity788 in one @entity1 (1/90 = 1%). Ten @entity1 (10/90 = 11%) had a radiologically confirmed @entity834 ; however only in four out of them with clinical manifestation; treatment was conservative in all four @entity1 . Major morbidity occurred in 27 @entity1 (27/90 = 30%). Overall rate of morbidity was significantly higher after three-field lymphadenectomy (85%) as compared to two-field lymphadenectomy (68.7%; P = 0.023). CONCLUSIONS: Chemoradiotherapy followed by resection of @entity15004 +/- cM1lymph @entity189 is feasible with acceptable mortality. Mortality, however, seems to be significantly higher when compared to a group of pT3M1LYM/pT4 @entity1 who underwent primary surgery (8.3 versus 2.3%; P = 0.015) in the same period in our department.

Effects of preoperative chemoradiotherapy on postsurgical morbidity and mortality in XXXX +/- cM1lymph cancer of the oesophagus and gastro-oesophageal junction.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1143 :: ('MESH:D010996', 'Disease') :: ['pleural effusion'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatitis'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity834 :: ('MESH:D057868', 'Disease') :: ['anastomotic leak'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhage'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Non-tumour'] @entity649 :: ('MESH:D012128', 'Disease') :: ['respiratory distress syndrome'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity189 :: ('MESH:D002277', 'Disease') :: ['oesophageal carcinoma'] @entity15004 :: ('158809', 'Gene') :: ['cT3-4'] @entity891 :: ('MESH:D001261', 'Disease') :: ['atelectasis'] @entity292 :: ('MESH:D005402', 'Disease') :: ['tracheal fistula'] @entity943 :: ('MESH:D001145', 'Disease') :: ['dysrhythmia'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity15004 :: (158809,Gene) :: ['cT3-4']
