Our Summary

The study looked at patients who had surgery to remove esophageal adenocarcinoma (a type of esophageal cancer) between 2000 and 2019. They found that 39% of these patients had their cancer come back. The chance of the cancer coming back in the same place (local recurrence) was 2.7% after 5 years. The cancer was more likely to return in the same place if the cancer was at a later stage, if the cancer cells had a specific appearance (signet ring histology), or if the patient had a serious complication.

Patients who had their cancer return in the same place and were treated with definitive therapy (a full treatment plan aimed at curing the cancer) lived a median of 19.1 months after their cancer came back. This is compared to 10.6 months for those treated with only chemotherapy or radiotherapy and 1.73 months for those who had no treatment.

The study concludes that only 3% of patients had their cancer return in the same place. They suggest that for some patients, a more aggressive treatment plan might be needed.

FAQs

  1. What percentage of patients had their esophageal adenocarcinoma return after surgery according to the study?
  2. What factors were found to increase the likelihood of the cancer returning in the same place?
  3. What was the median survival time for patients whose cancer returned and were treated with a full treatment plan versus those treated with only chemotherapy or radiotherapy or those who had no treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about esophagectomy is to closely follow their recommended treatment plan and attend all follow-up appointments to monitor for any signs of cancer recurrence. It is important to discuss any concerns or symptoms with your healthcare team promptly. Additionally, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can help support overall health and recovery after surgery.

Suitable For

Esophagectomy is typically recommended for patients with esophageal cancer, particularly those with adenocarcinoma. Patients who have early-stage cancer, are otherwise healthy, and are able to tolerate surgery are good candidates for esophagectomy. Additionally, patients who have not responded well to other treatments such as chemotherapy or radiation therapy may also be recommended for esophagectomy. It is important for patients to discuss their specific situation with their healthcare team to determine if esophagectomy is the best treatment option for them.

Timeline

Before esophagectomy:

  • Patient is diagnosed with esophageal adenocarcinoma
  • Patient undergoes preoperative testing and evaluation
  • Patient may undergo neoadjuvant therapy (chemotherapy and/or radiation therapy) before surgery
  • Patient undergoes esophagectomy surgery to remove the cancerous part of the esophagus
  • Patient recovers in the hospital for a period of time

After esophagectomy:

  • Patient may experience complications such as infection, leakage from the surgical site, or difficulty swallowing
  • Patient undergoes postoperative follow-up appointments and monitoring
  • Patient may undergo adjuvant therapy (chemotherapy and/or radiation therapy) after surgery
  • Patient may experience a recurrence of the cancer, either locally or in a different location
  • Patient may undergo further treatment for recurrent cancer, such as definitive therapy or palliative care
  • Patient’s prognosis and survival may depend on the stage of the cancer, the type of cancer cells, and any complications experienced during treatment.

What to Ask Your Doctor

  1. What is the success rate of esophagectomy for treating esophageal adenocarcinoma?
  2. What are the potential risks and complications associated with esophagectomy?
  3. What is the likelihood of the cancer coming back after surgery?
  4. What factors can increase the risk of the cancer coming back in the same place?
  5. What is the recommended follow-up plan after esophagectomy to monitor for recurrence?
  6. What treatment options are available if the cancer does come back?
  7. What is the prognosis for patients whose cancer comes back in the same place?
  8. Are there any specific factors in my case that may indicate the need for a more aggressive treatment plan?
  9. How can I reduce my risk of recurrence after esophagectomy?
  10. Are there any clinical trials or new treatment options that I should consider for my specific situation?

Reference

Authors: Carr RA, Harrington C, Vos E, Bains MS, Bott MJ, Isbell JM, Park BJ, Sihag S, Jones DR, Molena D. Journal: Ann Thorac Surg. 2022 Aug;114(2):418-425. doi: 10.1016/j.athoracsur.2021.07.101. Epub 2021 Sep 10. PMID: 34509415