72 / 1084
3/28/2017
14
TheRoyalMarsden
Resection Margin and Procedure
171 AEG Patients
16 Oesophagectomy
71 Left Thoraco-abdominal
84 Transhiatal
Margin: proximal limit of tumour above junction
> 5cm – oesophagectomy
3 – 5cm – left thoraco-abdominal
< 3cm - Transhiatal
Nakamura et al 2008, Hep Gastr 55:
1332-7
OPERATIVE MORBIDITY FOR JUNCTIONAL
PROCEDURES
SERIES
PROCEDURE
NO.
OPERATIVE
MORTALITY
OPERATIVE
MORBIDITY
SPECIFIC
MORBIDITY
Meyer etal
(2002)
TTO
LTAExt TG
56
74
5.3%
1.4%
41%
Respiratory
Lerutet al
(2004)
TTO
3 field
174
1.2%
58%
Respiratory
32.8%
Arrythmia 10.9%
Internulloet al
(2008)
LTA
94
(>75yrs)
7.4%
51.9%
Respiratory37%
Ott etal
(2009)
TTO
240
3.8%
17.9%
Respiratory
Liet al
(2011)
LTA
135
0%
11%
Respiratory6%
Leak 1%
Wound Infection
4%
Multimodality treatment of oesophageal cancer
Adenocarcinoma
Pre-operative
chemotherapy
Surgery
Pre-operative
chemotherapy
Surgery
Post-operative
chemotherapy
Pre-operative
chemoradiation
Surgery
Squamous cell carcinoma
Pre-operative
chemotherapy
Surgery
Definitive
Chemo-
radiation
Lymphadenectomy in Oesophago-Gastrectomy
83
Siewert et al 2002
Nodal Distribution in Type II
Frequency of Nodal Involvement
Pedrazzani et al 2007
Pedrazzani et al 2007