The study evaluates the validity of using pathological response as a surrogate marker for overall survival (OS) in neoadjuvant studies for esophageal cancer. A meta-analysis comprising 40 trials and 55,344 patients shows that the surrogacy between pathological complete response (PCR) and OS is moderate. The study establishes a lack of surrogacy at the trial level […]
Category: Upper Gastrointestinal Tract
No Significant Hernia Recurrence, but Increased Complications: Impact of Smoking on Minimally Invasive Paraesophageal Hernia Repair Outcomes
The impact of active smoking on outcomes of minimally invasive paraesophageal hernia repair (PEHR) was assessed in this cohort study. There was no significant difference in rates of death or serious morbidity (DSM) or hernia recurrence between smokers and non-smokers. However, on further analysis using the National Surgical Quality Improvement Program (NSQIP) database, smoking status […]
Effect of Procedural Volume on Adverse Outcomes in Gastric Endoscopic Submucosal Dissection
A nationwide population-based study investigated the influence of procedural volume on the outcome of gastric endoscopic submucosal dissection (ESD) for gastric cancer or adenoma. The study included 88,687 patients who underwent 94,246 procedures between November 2011 and December 2017. The results showed that high- and medium-volume centers had a significantly lower risk of adverse outcomes […]
Neoadjuvant Chemotherapy Improves Survival in Diffuse Type Gastric and Gastroesophageal Junction Carcinoma
Multimodal therapy, specifically neoadjuvant chemotherapy, was associated with increased survival in patients with diffuse type gastric and gastroesophageal junction carcinoma, including signet ring cell carcinoma. All-cause mortality within 90 days postoperatively was lower after neoadjuvant chemotherapy compared to primary surgery. Additionally, mortality remained lower in the neoadjuvant chemotherapy group even after 90 days post-surgery. These […]
Racial Disparity in Esophageal Cancer Treatment and Survival
Black individuals with esophageal squamous cell carcinoma (ESCC) have a lower survival rate compared to white individuals. This disparity could be attributed to presenting at a later stage of the disease and differences in treatment received, including chemotherapy, radiation, and surgery. Black individuals were less likely to receive these treatments even when diagnosed at the […]
Safety and Efficacy of Percutaneous Jejunostomy Tube Placement Outperforms Surgical Methods
A retrospective analysis comparing direct percutaneous endoscopic jejunostomy (DPEJ) tube placement with laparoscopic (Lap-J) and open laparotomy (Open-J) surgical methods revealed similar procedural success rates and complication rates in all three approaches. However, patients who underwent DPEJ experienced significantly lower rates of tube dysfunction within 90 days compared to surgical groups, primarily due to reduced […]
Fibrin Sealant Effectively Closes Mucosal Penetrations during Gastrointestinal Submucosal Tumor Resection
The study aimed to assess the efficacy and safety of using a fibrin sealant for closing mucosal penetrations at the esophagus or cardia during submucosal tunnelling endoscopic resection (STER) for gastrointestinal submucosal tumors. A total of 31 mucosal penetrations were identified in 30 patients who received the fibrin sealant. The results showed that the fibrin […]
Antimicrobial Prophylaxis with Ampicillin-Sulbactam Improves Short-term Outcomes after Esophagectomy
Antimicrobial prophylaxis with ampicillin-sulbactam was found to be more effective compared to cefazolin in reducing surgical site infection, anastomotic leakage, and respiratory failure after esophagectomy. In a study involving 17,772 patients, the use of ampicillin-sulbactam was associated with significantly improved short-term postoperative outcomes, including reduced respiratory complications, length of stay, and total hospitalization costs. No […]
Safety and Efficacy of Percutaneous Jejunostomy Tube Placement Outperforms Surgical Methods
A retrospective analysis comparing direct percutaneous endoscopic jejunostomy (DPEJ) tube placement with laparoscopic (Lap-J) and open laparotomy (Open-J) surgical methods revealed similar procedural success rates and complication rates in all three approaches. However, patients who underwent DPEJ experienced significantly lower rates of tube dysfunction within 90 days compared to surgical groups, primarily due to reduced […]
Patients’ Preferences for Decision Counseling in Esophageal Cancer
Patients with esophageal cancer were offered decision counseling (dc) either before or after neoadjuvant chemoradiotherapy (ncrt) to reflect on their treatment preferences. Interviews with patients revealed that those who received counseling before ncrt were satisfied with the timing, while some patients who received counseling after ncrt would have preferred it earlier. Overall, patients had positive […]