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dc.contributor.authorDavies, ARen_US
dc.contributor.authorZylstra, Jen_US
dc.contributor.authorBaker, CRen_US
dc.contributor.authorGossage, JAen_US
dc.contributor.authorDellaportas, Den_US
dc.contributor.authorLagergren, Jen_US
dc.contributor.authorFindlay, JMen_US
dc.contributor.authorPuccetti, Fen_US
dc.contributor.authorEl Lakis, Men_US
dc.contributor.authorDrummond, RJen_US
dc.contributor.authorDutta, Sen_US
dc.contributor.authorMera, Aen_US
dc.contributor.authorVan Hemelrijck, Men_US
dc.contributor.authorForshaw, MJen_US
dc.contributor.authorMaynard, NDen_US
dc.contributor.authorAllum, WHen_US
dc.contributor.authorLow, Den_US
dc.contributor.authorMason, RCen_US
dc.date.accessioned2018-03-02T12:55:55Z
dc.date.issued2018-03-01en_US
dc.identifier.citationDiseases of the Esophagus, 2018, 31 (3)en_US
dc.identifier.issn1120-8694en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1484
dc.identifier.eissn1442-2050en_US
dc.identifier.doi10.1093/dote/dox129en_US
dc.description.abstract<jats:title>SUMMARY</jats:title> <jats:p>The purpose of this study was to assess the oncological outcomes of a large multicenter series of left thoracoabdominal esophagectomies, and compare these to the more widely utilized Ivor–Lewis esophagectomy. With ethics approval and an established study protocol, anonymized data from five centers were merged into a structured database. The study exposure was operative approach (ILE or LTE). The primary outcome measure was time to death. Secondary outcome measures included time to tumor recurrence, positive surgical resection margins, lymph node yield, postoperative death, and hospital length of stay. Cox proportional hazards models provided hazard ratios (HR) with 95% confidence intervals (CI) adjusting for age, pathological tumor stage, tumor grade, lymphovascular invasion, and neoadjuvant treatment. Among 1228 patients (598 ILE; 630 LTE), most (86%) had adenocarcinoma (AC) and were male (81%). Comparing ILE and LTE for AC patients, no difference was seen in terms of time to death (HR 0.904 95%CI 0.749–1.1090) or time to recurrence (HR 0.973 95%CI 0.768–1.232). The risk of a positive resection margin was also similar (OR 1.022 95%CI 0.731–1.429). Median lymph node yield did not differ between approaches (LTE 21; ILE 21; P = 0.426). In-hospital mortality was 2.4%, significantly lower in the LTE group (LTE 1.3%; ILE 3.6%; P = 0.004). Median hospital stay was 11 days in the LTE group and 14 days in the ILE group (P &lt; 0.0001). In conclusion, this is the largest series of left thoracoabdominal esophagectomies to be submitted for publication and the only one to compare two different transthoracic esophagectomy strategies. It demonstrates oncological equivalence between operative approaches but possible short- term advantages to the left thoracoabdominal esophagectomy.</jats:p>en_US
dc.languageenen_US
dc.language.isoenen_US
dc.publisherOxford University Press (OUP)en_US
dc.titleA comparison of the left thoracoabdominal and Ivor–Lewis esophagectomyen_US
dc.typeJournal Article
rioxxterms.versionofrecord10.1093/dote/dox129en_US
rioxxterms.licenseref.startdate2018-03-01en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfDiseases of the Esophagusen_US
pubs.issue3en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume31en_US
pubs.embargo.termsNot knownen_US
dc.contributor.icrauthorMarsden,en_US


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