61 / 1084
3/28/2017
3
CROSS Trial
13
TheRoyalMarsden
Minimally Invasive Oesophagectomy
101 open;
65 MIO;
9 Conversion
pT1a & pT1b. N0
Intraoperative Morbidity MediumTerm
MIO
Less blood loss
Gastroparesis
Less pain
OPEN
Shorter time
Respiratory
More fatigued
Nafteux et al 2011 Eur J Cardio Surgery 40: 1455
Minimally Invasive Oesophageal Resection
MIRO
No. Morbid.
Pulm
Compl
30day
mort.
HMIO 103 35.9% 17.7% 4.9%
TTO 104 64.4% 30.1% 4.9%
TIME
No.
Pulm
Compl
InHosp
Mort.
MIO
59
12%
3%
TTO
56
34%
2%
NutritionalaspectsofEnhancedRecovery
15
Marietteetal2015 JClinOnc33: suppl3: abstr5
Biereetal2012 LancetOnc;379:1887
Chemoradiation / Surgery vs Chemoradiation
FFCD12
16
Bedenne etal2007 JClinOncol25:1160
Survival ITT
Survival per protocol
TheRoyalMarsden
Salvage Surgery after Definitive Chemoradiotherapy for SCC
17
Persistent disease - 234
Recurrent disease - 74
Anastomotic leak – 17.2%
Surgical site infection – 18.5%
Pulmonary complications – 42.9%
Markaret al 2015; J Clin Onc 33: 3866
Salvage Oesophagectomy
18
PERS – Persistent
REC - Recurrent