At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3. POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%). Surgeons should consider the higher GERD incidence with POEM when selecting treatment. Symptomatic recurrence at 5 years was low in […]
Category: Upper Gastrointestinal Tract
Muscle Loss Impacts Survival in Advanced Esophageal Cancer
Excessive muscle loss during neoadjuvant therapy significantly predicts survival outcomes in locally advanced esophageal squamous cell carcinoma. Among 421 patients, 5-year overall survival was 60%, with 26.6% experiencing muscle loss during the initial treatment. Muscle loss at two points during therapy was linked to a higher risk of mortality (stage A HR 1.78; stage B […]
Outcomes Similar for Immune Therapy After Nivolumab in Esophageal Cancer
First-line immune checkpoint inhibitor therapy for esophageal cancer recurrence shows no advantage based on prior adjuvant nivolumab treatment. Among 81 patients, early tumor shrinkage rates were similar between those with and without prior nivolumab exposure. No differences in progression-free survival (HR 1.4) or overall survival (HR 1.23), with 2-year overall survival at approximately 44%. This […]
Standardized Endoscopy Could Improve Gastric Cancer Outcomes
Diagnostic endoscopy for gastric cancer is underused, leading to late-stage diagnoses and worse survival rates. 73% of stage I gastric cancer patients are symptomatic, yet many are diagnosed late. Median overall survival varies drastically: 47 months for stage II versus 11 months for stage IV. Surgeons should advocate for standardized endoscopy protocols to improve early […]
Endoscopic dissection proves effective for early esophageal cancer
Endoscopic submucosal dissection (ESD) can be a viable option for patients with esophageal squamous high-grade dysplasia and early squamous cell carcinoma, challenging the conventional referral for surgical intervention. Curative resection rates were significantly higher for absolute criteria lesions at 71.8%, compared to just 19.4% for outside criteria lesions. Of the outside criteria group, nearly 20% […]
Endoscopic and Surgical Advances in Achalasia Treatment
Minimally invasive strategies are transforming achalasia management. Laparoscopic myotomy, POEM, and emerging techniques like peroral oesophageal plication show promising outcomes. Individualized treatment based on high-resolution manometry, patient co-morbidities, and procedural risks is now essential. Comprehensive treatment offers significant symptom relief and quality-of-life improvement. Addressing post-treatment reflux and surveillance for malignancy remains critical for long-term patient […]
Improved Prognosis in Duodenal Adenocarcinoma Staging
Log odds of positive lymph nodes classification enhances survival predictions in duodenal adenocarcinoma, crucial for surgical decision-making. Standardized log odds showed strong predictive accuracy: c-index of 0.639 in a U.S. cohort and 0.679 in a Chinese cohort. A nomogram incorporating log odds, age, T-stage, and treatment achieved a 5-year area under the curve of 0.735, […]
Understanding Prognosis for Esophageal Basaloid Carcinoma
A study of 803 patients shows esophageal basaloid squamous cell carcinoma (EBSCC) has a similar overall survival to conventional esophageal squamous cell carcinoma (ESCC) post-surgery, despite unique challenges. Only 4.1% of patients had EBSCC; neoadjuvant chemotherapy response was poor—0% pathologic response > grade 2 vs. 27.8% for ESCC. Recurrence rates: 33.3% for EBSCC vs. 28.3% […]
Delayed Recovery in Gastrectomy: Total vs. Other Procedures
Total gastrectomy patients experience slower recovery and greater symptom burden compared to other types of gastrectomy. Recovery rates for total gastrectomy were 63% at one month and only 75% by six months, compared to 79% and 96% for other procedures. Open total gastrectomy had a significantly lower odds ratio for recovery (0.28) compared to robotic […]
Advancements in Achalasia Treatment Enhance Outcomes
New strategies in achalasia management are improving surgical and endoscopic outcomes for better patient care. Minimally invasive techniques like robotic myotomy and POEM have significant advantages over traditional methods. Treatment can now be tailored based on manometric subtype, esophageal structure, and patient health, increasing success rates. Surgeons should prioritize individualized treatment plans to enhance patient […]