Upper GI 2017

3/28/2017

TheRoyalMarsden

32

TheRoyalMarsden

NutritionalaspectsofEnhancedRecovery

Survival by CRM

CRM in Neoadjuvant Trials

CS

S

CF ECX CXRT S

OEO2 25% 28% OEO5

41% 33%

CROSS

8% 30%

Radical Surgery – 13% - 2/62

O’Neill et al. BJS 2013; 100:1055-63

TheRoyalMarsden

Positive margin vs negative margin

Survival after Treatment for CRM+

Pre-op Staging

Margin positive

Margin negative

T3N0 T3N1 T3N2

10% 40% 50%

T3N0 nor T1-2N0/1 40%

50% 10%

Median no +LN Mean No +LN

5

0

6.3

1.6

O’Neill et al. BJS 2013; 100:1055-63

35

TheRoyalMarsden

Aim of Resection

Survival by Number examined in N0 Disease Bollschweiller et al 2006

Complete resection of primary tumour (R0)

Clear margins

Lymphadenectomy (>15 nodes)

Bollschweiler et al 2006

6