Upper GI 2017

3/28/2017

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

Chemoradiation / Surgery vs Chemoradiation FFCD12 16

15

NutritionalaspectsofEnhancedRecovery

Minimally Invasive Oesophageal Resection

MIRO

TIME

Survival ITT

No. Morbid. 30day mort. HMIO 103 35.9% 17.7% 4.9% Pulm Compl

No.

Pulm Compl

InHosp Mort.

MIO

59

12%

3%

TTO 104 64.4% 30.1% 4.9%

TTO

56

34%

2%

Survival per protocol

Marietteetal2015 JClinOnc33: suppl3: abstr5

Biereetal2012 LancetOnc;379:1887

Bedenne etal2007 JClinOncol25:1160

17

TheRoyalMarsden

18

Salvage Oesophagectomy

Salvage Surgery after Definitive Chemoradiotherapy for SCC

Persistent disease - 234

Recurrent disease - 74

PERS – Persistent

Anastomotic leak – 17.2%

REC - Recurrent

Surgical site infection – 18.5%

Pulmonary complications – 42.9%

Markaret al 2015; J Clin Onc 33: 3866

3