title: Simultaneous Resection of Synchronous Esophageal and Gastric Cancers.
abstract: BackgroundIn patients with synchronous esophageal and gastric cancers, selecting an optimal conduit for esophageal reconstruction is a critical decision. The aim of this study was to evaluate the surgical outcomes after simultaneous resection of esophageal and gastric cancers according to the type of esophageal conduit used.Materials and MethodsClinicopathologic features and surgical outcomes were analyzed in 66 patients who underwent esophageal reconstruction with colon (n= 41, group C), jejunum (n= 11, group J), and stomach (n= 14, group S).ResultsGastric cancer was adenocarcinoma and esophageal cancer was squamous cell carcinoma in every case. Inhospital mortality rate was 4.6% (n= 3). The complication rates were 6.1% for graft failure and 9.1% for anastomotic leakage. During the follow-up period (mean, 44.0 ± 49.6 months), 5-year overall and disease-free survivals were 50.6 and 48.1%, respectively. Especially, patient with stage I cancer for both esophageal and gastric lesion showed excellent survival outcome with 5-year overall survival rate of 82.0%. There were no significant differences in early mortality, incidence of graft complications or overall survival between the groups. The independent predictors of overall survival were the highest tumor stage (p= 0.008) and age (p= 0.009).ConclusionSimultaneous resection of gastric and esophageal cancers can be performed with reasonable early and late outcomes. The type of esophageal conduit used was not a determinant factor for early and late outcomes.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Byungjoon
authors.initials: B
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Hong Kwan
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Zo
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003106:Colon / Q000637:transplantation; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality; D018530:Gastric Stump / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome