Search

Your search keyword '"Cheong, Edward"' showing total 25 results
Start Over Author "Cheong, Edward" Database OAIster
25 results on '"Cheong, Edward"'

1. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R, Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023
Full Text
View/download PDF

2. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R, Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023
Full Text
View/download PDF

3. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R, Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023
Full Text
View/download PDF

4. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R, Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023
Full Text
View/download PDF

5. Management of paraesophageal hiatus hernia:recommendations following a European expert Delphi consensus

Author

Gerdes, Stephan, Schoppmann, Sebastian F., Bonavina, Luigi, Boyle, Nicholas, Müller-Stich, Beat P., Gutschow, Christian A., Gisbertz, Suzanne Sarah, Köckerling, Ferdinand, Lehmann, Thorsten G., Lorenz, Dietmar, Granderath, Frank Alexander, Rosati, Riccardo, Wullstein, Christoph, Lundell, Lars, Cheong, Edward, Nafteux, Philippe, Olmi, Stefano, Mönig, Stefan, Biebl, Matthias, Leers, Jessica, Zehetner, Joerg, Kristo, Ivan, Berrisford, Richard George, Skrobić, Ognjan M., Simić, Aleksandar P., Pera, Manuel, Grimminger, Peter Philipp, Gockel, Ines, Zarras, Konstantinos, Nieuwenhuijs, Vincent Bernard, Gossage, James A., van Berge Henegouwen, Mark i., Stein, Hubert J., Markar, Sheraz R., Hueting, Willem Eduard, Targarona, Eduardo M., Johansson, Jan, Macaulay, Graeme D., Wijnhoven, Bas P.L., Benedix, Frank, Attwood, Stephen E., Hölscher, Arnulf Heinrich, Priego, Pablo, Fuchs, Karl Hermann, Luyer, Misha D.P., Griffiths, Ewen A., Søvik, Torgeir Thorson, Theodorou, Dimitrios, Sgromo, Bruno, Salo, Jarmo A., Gerdes, Stephan, Schoppmann, Sebastian F., Bonavina, Luigi, Boyle, Nicholas, Müller-Stich, Beat P., Gutschow, Christian A., Gisbertz, Suzanne Sarah, Köckerling, Ferdinand, Lehmann, Thorsten G., Lorenz, Dietmar, Granderath, Frank Alexander, Rosati, Riccardo, Wullstein, Christoph, Lundell, Lars, Cheong, Edward, Nafteux, Philippe, Olmi, Stefano, Mönig, Stefan, Biebl, Matthias, Leers, Jessica, Zehetner, Joerg, Kristo, Ivan, Berrisford, Richard George, Skrobić, Ognjan M., Simić, Aleksandar P., Pera, Manuel, Grimminger, Peter Philipp, Gockel, Ines, Zarras, Konstantinos, Nieuwenhuijs, Vincent Bernard, Gossage, James A., van Berge Henegouwen, Mark i., Stein, Hubert J., Markar, Sheraz R., Hueting, Willem Eduard, Targarona, Eduardo M., Johansson, Jan, Macaulay, Graeme D., Wijnhoven, Bas P.L., Benedix, Frank, Attwood, Stephen E., Hölscher, Arnulf Heinrich, Priego, Pablo, Fuchs, Karl Hermann, Luyer, Misha D.P., Griffiths, Ewen A., Søvik, Torgeir Thorson, Theodorou, Dimitrios, Sgromo, Bruno, and Salo, Jarmo A.

Abstract

Aims: There is considerable controversy regarding optimal management of patients with paraesophageal hiatus hernia (pHH). This survey aims at identifying recommended strategies for work-up, surgical therapy, and postoperative follow-up using Delphi methodology. Methods: We conducted a 2-round, 33-question, web-based Delphi survey on perioperative management (preoperative work-up, surgical procedure and follow-up) of non-revisional, elective pHH among European surgeons with expertise in upper-GI. Responses were graded on a 5-point Likert scale and analyzed using descriptive statistics. Items from the questionnaire were defined as “recommended” or “discouraged” if positive or negative concordance among participants was > 75%. Items with lower concordance levels were labelled “acceptable” (neither recommended nor discouraged). Results: Seventy-two surgeons with a median (IQR) experience of 23 (14–30) years from 17 European countries participated (response rate 60%). The annual median (IQR) individual and institutional caseload was 25 (15–36) and 40 (28–60) pHH-surgeries, respectively. After Delphi round 2, “recommended” strategies were defined for preoperative work-up (endoscopy), indication for surgery (typical symptoms and/or chronic anemia), surgical dissection (hernia sac dissection and resection, preservation of the vagal nerves, crural fascia and pleura, resection of retrocardial lipoma) and reconstruction (posterior crurorrhaphy with single stitches, lower esophageal sphincter augmentation (Nissen or Toupet), and postoperative follow-up (contrast radiography). In addition, we identified “discouraged” strategies for preoperative work-up (endosonography), and surgical reconstruction (crurorrhaphy with running sutures, tension-free hiatus repair with mesh only). In contrast, many items from the questionnaire including most details of mesh augmentation (indication, material, shape, placement, and fixation technique) were “acceptable”. Conclusions: This multina

Published
2023

6. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer:a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, van Berge Henegouwen, Mark I., van Hillegesberg, Richard, Watson, David I., Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R., Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, van Berge Henegouwen, Mark I., van Hillegesberg, Richard, Watson, David I., Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R.

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023

7. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R, Chidambaram, Swathikan, Patel, Nikhil M, Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A, Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H, Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B Mark, van Berge Henegouwen, Mark I, van Hillegesberg, Richard, Watson, David I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R

Abstract

BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2023
Full Text
View/download PDF

8. Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics A Retrospective Multinational Cohort Study

Author

Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, Rosman, C., Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, and Rosman, C.

Abstract

Item does not contain fulltext

Published
2022

9. Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics A Retrospective Multinational Cohort Study

Author

Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, Rosman, C., Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, and Rosman, C.

Abstract

Contains fulltext : 250180.pdf (Publisher’s version ) (Open Access)

Published
2022

10. Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics A Retrospective Multinational Cohort Study

Author

Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, Rosman, C., Claassen, L., Hannink, G., Luyer, Misha D. P., Ainsworth, Alan P., Berge Henegouwen, M.I. van, Cheong, Edward, Klarenbeek, B.R., Workum, F.T.W.E. van, and Rosman, C.

Abstract

Contains fulltext : 250180.pdf (Publisher’s version ) (Open Access)

Published
2022

11. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, Tiuri E., van Hillegersberg, Richard, Schoppmann, Sebastian, Deseyne, Pieter R. A. J., Nafteux, Philippe, Obermannova, Radka, Nordsmark, Marianne, Pfeiffer, Per, Hawkins, Maria A., Smyth, Elizabeth, Markar, Sheraz, Hanna, George B., Cheong, Edward, Chaudry, Asif, Elme, Anneli, Adenis, Antoine, Piessen, Guillaume, Gani, Cihan, Bruns, Christiane J., Moehler, Markus, Liakakos, Theodore, Reynolds, John, Morganti, Alessio, Rosati, Riccardo, Castoro, Carlo, D'Ugo, Domenico, Roviello, Franco, Bencivenga, Maria, de Manzoni, Giovanni, Jeene, Paul, van Sandick, Johanna W., Muijs, Christel, Slingerland, Marije, Nieuwenhuijzen, Grard, Wijnhoven, Bas, Beerepoot, Laurens, V, Kolodziejczyk, Piotr, Polkowski, Wojciech P., Alsina, Maria, Pera, Manuel, Kanonnikoff, Tania F., Nilsson, Magnus, Guckenberger, Matthias, Monig, Stefan, Wagner, Dorethea, Wyrwicz, Lucjan, Berbee, Maaike, Gockel, Ines, Lordick, Florian, Griffiths, Ewen A., Verheij, Marcel, van Rossum, Peter S. N., van Laarhoven, Hanneke W. M., Kroese, Tiuri E., van Hillegersberg, Richard, Schoppmann, Sebastian, Deseyne, Pieter R. A. J., Nafteux, Philippe, Obermannova, Radka, Nordsmark, Marianne, Pfeiffer, Per, Hawkins, Maria A., Smyth, Elizabeth, Markar, Sheraz, Hanna, George B., Cheong, Edward, Chaudry, Asif, Elme, Anneli, Adenis, Antoine, Piessen, Guillaume, Gani, Cihan, Bruns, Christiane J., Moehler, Markus, Liakakos, Theodore, Reynolds, John, Morganti, Alessio, Rosati, Riccardo, Castoro, Carlo, D'Ugo, Domenico, Roviello, Franco, Bencivenga, Maria, de Manzoni, Giovanni, Jeene, Paul, van Sandick, Johanna W., Muijs, Christel, Slingerland, Marije, Nieuwenhuijzen, Grard, Wijnhoven, Bas, Beerepoot, Laurens, V, Kolodziejczyk, Piotr, Polkowski, Wojciech P., Alsina, Maria, Pera, Manuel, Kanonnikoff, Tania F., Nilsson, Magnus, Guckenberger, Matthias, Monig, Stefan, Wagner, Dorethea, Wyrwicz, Lucjan, Berbee, Maaike, Gockel, Ines, Lordick, Florian, Griffiths, Ewen A., Verheij, Marcel, van Rossum, Peter S. N., and van Laarhoven, Hanneke W. M.

Abstract

Background: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods: European expert centers (n Z 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into up -front local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (< 50%), fair (50%-75%), or consensus (>= 75%). Results: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1-2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. Conclusion: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of

Published
2022

12. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer: a modified Delphi consensus process

Author

Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, Henegouwen, Mark I. van Berge, van Hillegesberg, Richard, Watson, David, I, Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R., Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, Henegouwen, Mark I. van Berge, van Hillegesberg, Richard, Watson, David, I, Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R.

Abstract

Background: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. Methods: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. Results: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. Conclusion: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Published
2022

13. Lasting Symptoms After Esophageal Resection (LASER):European Multicenter Cross-sectional Study

Author

Markar, Sheraz R., Zaninotto, Giovanni, Castoro, Carlo, Johar, Asif, Lagergren, Pernilla, Elliott, Jessie A., Gisbertz, Suzanne S., Mariette, Christophe, Alfieri, Rita, Huddy, Jeremy, Sounderajah, Viknesh, Pinto, Eleonora, Scarpa, Marco, Klevebro, Fredrik, Sunde, Berit, Murphy, Conor F., Greene, Christine, Ravi, Narayanasamy, Piessen, Guillaume, Brenkman, Hylke, Ruurda, Jelle P., Van Hillegersberg, Richard, Lagarde, Sjoerd, Wijnhoven, Bas, Pera, Manuel, Roig, José, Castro, Sandra, Matthijsen, Robert, Findlay, John, Antonowicz, Stefan, Maynard, Nick, Mccormack, Orla, Ariyarathenam, Arun, Sanders, Grant, Cheong, Edward, Jaunoo, Shameen, Allum, William, Van Lanschot, Jan, Nilsson, Magnus, Reynolds, John V., Henegouwen, Mark I.van Berge, Hanna, George B., Markar, Sheraz R., Zaninotto, Giovanni, Castoro, Carlo, Johar, Asif, Lagergren, Pernilla, Elliott, Jessie A., Gisbertz, Suzanne S., Mariette, Christophe, Alfieri, Rita, Huddy, Jeremy, Sounderajah, Viknesh, Pinto, Eleonora, Scarpa, Marco, Klevebro, Fredrik, Sunde, Berit, Murphy, Conor F., Greene, Christine, Ravi, Narayanasamy, Piessen, Guillaume, Brenkman, Hylke, Ruurda, Jelle P., Van Hillegersberg, Richard, Lagarde, Sjoerd, Wijnhoven, Bas, Pera, Manuel, Roig, José, Castro, Sandra, Matthijsen, Robert, Findlay, John, Antonowicz, Stefan, Maynard, Nick, Mccormack, Orla, Ariyarathenam, Arun, Sanders, Grant, Cheong, Edward, Jaunoo, Shameen, Allum, William, Van Lanschot, Jan, Nilsson, Magnus, Reynolds, John V., Henegouwen, Mark I.van Berge, and Hanna, George B.

Abstract

Objective:To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors.Background:Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood.Patients and Methods:Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool.Results:A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively.Conclusion:Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.

Published
2022

14. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, Tiuri E., van Hillegersberg, Richard, Schoppmann, Sebastian, Deseyne, Pieter R.A.J., Nafteux, Philippe, Obermannova, Radka, Nordsmark, Marianne, Pfeiffer, Per, Hawkings, Maria A., Smyth, Elizabeth, Markar, Sheraz, Hanna, George B., Cheong, Edward, Chaudry, Asif, Elme, Anneli, Adenis, Antoine, Piessen, Guillaume, Gani, Cihan, Bruns, Christiane J., Moehler, Markus, Liakakos, Theodore, Reynolds, John, Morganti, Alessio, Rosati, Riccardo, Castoro, Carlo, D'Ugo, Domenico, Roviello, Franco, Bencivenga, Maria, de Manzoni, Giovanni, Jeene, Paul, van Sandick, Johanna W., Muijs, Christel, Slingerland, Marije, Nieuwenhuijzen, Grard, Wijnhoven, Bas, Beerepoot, Laurens V., Kolodziejczyk, Piotr, Polkowski, Wojciech P., Alsina, Maria, Pera, Manuel, Kanonnikoff, Tania F., Nilsson, Magnus, Guckenberger, Matthias, Monig, Stefan, Wagner, Dorethea, Wyrwicz, Lucjan, Berbee, Maaike, Gockel, Ines, Lordick, Florian, Griffiths, Ewen A., Kroese, Tiuri E., van Hillegersberg, Richard, Schoppmann, Sebastian, Deseyne, Pieter R.A.J., Nafteux, Philippe, Obermannova, Radka, Nordsmark, Marianne, Pfeiffer, Per, Hawkings, Maria A., Smyth, Elizabeth, Markar, Sheraz, Hanna, George B., Cheong, Edward, Chaudry, Asif, Elme, Anneli, Adenis, Antoine, Piessen, Guillaume, Gani, Cihan, Bruns, Christiane J., Moehler, Markus, Liakakos, Theodore, Reynolds, John, Morganti, Alessio, Rosati, Riccardo, Castoro, Carlo, D'Ugo, Domenico, Roviello, Franco, Bencivenga, Maria, de Manzoni, Giovanni, Jeene, Paul, van Sandick, Johanna W., Muijs, Christel, Slingerland, Marije, Nieuwenhuijzen, Grard, Wijnhoven, Bas, Beerepoot, Laurens V., Kolodziejczyk, Piotr, Polkowski, Wojciech P., Alsina, Maria, Pera, Manuel, Kanonnikoff, Tania F., Nilsson, Magnus, Guckenberger, Matthias, Monig, Stefan, Wagner, Dorethea, Wyrwicz, Lucjan, Berbee, Maaike, Gockel, Ines, Lordick, Florian, and Griffiths, Ewen A.

Abstract

Background: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%–75%), or consensus (≥75%). Results: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1–2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. Conclusion: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs o

Published
2022

15. Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer: a modified Delphi consensus process

Author

MS CGO, Cancer, Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, van Berge Henegouwen, Mark I., van Hillegesberg, Richard, Watson, David I., Vohra, Ravinder, Maynard, Nick, Markar, Sheraz R., MS CGO, Cancer, Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita, Bonavina, Luigi, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, van Berge Henegouwen, Mark I., van Hillegesberg, Richard, Watson, David I., Vohra, Ravinder, Maynard, Nick, and Markar, Sheraz R.

Published
2022

16. Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study

Author

MS CGO, Cancer, Markar, Sheraz R, Zaninotto, Giovanni, Castoro, Carlo, Johar, Asif, Lagergren, Pernilla, Elliott, Jessie A, Gisbertz, Suzanne S, Mariette, Christophe, Alfieri, Rita, Huddy, Jeremy, Sounderajah, Viknesh, Pinto, Eleonora, Scarpa, Marco, Klevebro, Fredrik, Sunde, Berit, Murphy, Conor F, Greene, Christine, Ravi, Narayanasamy, Piessen, Guillaume, Brenkman, Hylke, Ruurda, Jelle P, Van Hillegersberg, Richard, Lagarde, Sjoerd, Wijnhoven, Bas, Pera, Manuel, Roig, José, Castro, Sandra, Matthijsen, Robert, Findlay, John, Antonowicz, Stefan, Maynard, Nick, McCormack, Orla, Ariyarathenam, Arun, Sanders, Grant, Cheong, Edward, Jaunoo, Shameen, Allum, William, Van Lanschot, Jan, Nilsson, Magnus, Reynolds, John V, Henegouwen, Mark I van Berge, Hanna, George B, MS CGO, Cancer, Markar, Sheraz R, Zaninotto, Giovanni, Castoro, Carlo, Johar, Asif, Lagergren, Pernilla, Elliott, Jessie A, Gisbertz, Suzanne S, Mariette, Christophe, Alfieri, Rita, Huddy, Jeremy, Sounderajah, Viknesh, Pinto, Eleonora, Scarpa, Marco, Klevebro, Fredrik, Sunde, Berit, Murphy, Conor F, Greene, Christine, Ravi, Narayanasamy, Piessen, Guillaume, Brenkman, Hylke, Ruurda, Jelle P, Van Hillegersberg, Richard, Lagarde, Sjoerd, Wijnhoven, Bas, Pera, Manuel, Roig, José, Castro, Sandra, Matthijsen, Robert, Findlay, John, Antonowicz, Stefan, Maynard, Nick, McCormack, Orla, Ariyarathenam, Arun, Sanders, Grant, Cheong, Edward, Jaunoo, Shameen, Allum, William, Van Lanschot, Jan, Nilsson, Magnus, Reynolds, John V, Henegouwen, Mark I van Berge, and Hanna, George B

Published
2022

17. Technique of open and minimally invasive intrathoracic reconstruction following esophagectomy-an expert consensus based on a modified Delphi process

Author

Bartella, Isabel, Fransen, Laura F. C., Gutschow, Christian A., Bruns, Christiane J., Henegouwen, Mark L. van Berge, Chaudry, M. Asif, Cheong, Edward, Cuesta, Miguel A., Van Daele, Elke, Gisbertz, Suzanne S., van Hillegersberg, Richard, Hoelscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Rasanen, Jari, Rosman, Camiel, Ruurda, Jelle P., Schneider, Paul M., Sgromo, Bruno, Nieuwenhuijzen, Grard A., Luyer, Misha D. P., Schroeder, Wolfgang, Bartella, Isabel, Fransen, Laura F. C., Gutschow, Christian A., Bruns, Christiane J., Henegouwen, Mark L. van Berge, Chaudry, M. Asif, Cheong, Edward, Cuesta, Miguel A., Van Daele, Elke, Gisbertz, Suzanne S., van Hillegersberg, Richard, Hoelscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Rasanen, Jari, Rosman, Camiel, Ruurda, Jelle P., Schneider, Paul M., Sgromo, Bruno, Nieuwenhuijzen, Grard A., Luyer, Misha D. P., and Schroeder, Wolfgang

Abstract

Background: In recent years, minimally invasive Ivor Lewis (IL) esophagectomy with high intrathoracic anastomosis has emerged as surgical standard of care for esophageal cancer in expert centers. Alongside this process, many divergent technical aspects of this procedure have been devised in different centers. This study aims at achieving international consensus on the surgical steps of IL reconstruction using Delphi methodology. Methods: The expert panel consisted of specialized esophageal surgeons from 8 European countries. During a two-round Delphi process, a detailed analysis and consensus on key steps of intrathoracic gastric tube reconstruction (IL esophagectomy) was performed. Results: Response rates in Delphi rounds 1 and 2 were 100% (22 of 22 experts) and 83.3% (20 of 24 experts), respectively. Three essential technical areas of intrathoracic gastric tube reconstruction were identified: first, vascularization of the gastric conduit, second, gastric mobilization, tube formation and pull-up, and third, anastomotic technique. In addition, 3 main techniques for minimally invasive intrathoracic anastomosis are currently practiced: (i) end-to-side circular stapled, (ii) end-to-side double stapling, and (iii) side-to-side linear stapled technique. The step-by-step procedural analysis unveiled common approaches but also different expert practice. Conclusion: This precise technical description may serve as a clinical guideline for intrathoracic reconstruction after esophagectomy. In addition, the results may aid to harmonize the technical evolution of this complex surgical procedure and thereby facilitate surgical training.

Published
2021

18. Technique of open and minimally invasive intrathoracic reconstruction following esophagectomy-an expert consensus based on a modified Delphi process

Author

Bartella, Isabel, Fransen, Laura F. C., Gutschow, Christian A., Bruns, Christiane J., Henegouwen, Mark L. van Berge, Chaudry, M. Asif, Cheong, Edward, Cuesta, Miguel A., Van Daele, Elke, Gisbertz, Suzanne S., van Hillegersberg, Richard, Hoelscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Rasanen, Jari, Rosman, Camiel, Ruurda, Jelle P., Schneider, Paul M., Sgromo, Bruno, Nieuwenhuijzen, Grard A., Luyer, Misha D. P., Schroeder, Wolfgang, Bartella, Isabel, Fransen, Laura F. C., Gutschow, Christian A., Bruns, Christiane J., Henegouwen, Mark L. van Berge, Chaudry, M. Asif, Cheong, Edward, Cuesta, Miguel A., Van Daele, Elke, Gisbertz, Suzanne S., van Hillegersberg, Richard, Hoelscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Rasanen, Jari, Rosman, Camiel, Ruurda, Jelle P., Schneider, Paul M., Sgromo, Bruno, Nieuwenhuijzen, Grard A., Luyer, Misha D. P., and Schroeder, Wolfgang

Abstract

Background: In recent years, minimally invasive Ivor Lewis (IL) esophagectomy with high intrathoracic anastomosis has emerged as surgical standard of care for esophageal cancer in expert centers. Alongside this process, many divergent technical aspects of this procedure have been devised in different centers. This study aims at achieving international consensus on the surgical steps of IL reconstruction using Delphi methodology. Methods: The expert panel consisted of specialized esophageal surgeons from 8 European countries. During a two-round Delphi process, a detailed analysis and consensus on key steps of intrathoracic gastric tube reconstruction (IL esophagectomy) was performed. Results: Response rates in Delphi rounds 1 and 2 were 100% (22 of 22 experts) and 83.3% (20 of 24 experts), respectively. Three essential technical areas of intrathoracic gastric tube reconstruction were identified: first, vascularization of the gastric conduit, second, gastric mobilization, tube formation and pull-up, and third, anastomotic technique. In addition, 3 main techniques for minimally invasive intrathoracic anastomosis are currently practiced: (i) end-to-side circular stapled, (ii) end-to-side double stapling, and (iii) side-to-side linear stapled technique. The step-by-step procedural analysis unveiled common approaches but also different expert practice. Conclusion: This precise technical description may serve as a clinical guideline for intrathoracic reconstruction after esophagectomy. In addition, the results may aid to harmonize the technical evolution of this complex surgical procedure and thereby facilitate surgical training.

Published
2021

19. Technique of open and minimally invasive intrathoracic reconstruction following esophagectomy-an expert consensus based on a modified Delphi process

Author

MS CGO, Cancer, Bartella, Isabel, Fransen, Laura F C, Gutschow, Christian A, Bruns, Christiane J, van Berge Henegouwen, Mark L, Chaudry, M Asif, Cheong, Edward, Cuesta, Miguel A, Van Daele, Elke, Gisbertz, Suzanne S, van Hillegersberg, Richard, Hölscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Räsanen, Jari, Rosman, Camiel, Ruurda, Jelle P, Schneider, Paul M, Sgromo, Bruno, Nieuwenhuijzen, Grard A, Luyer, Misha D P, Schröder, Wolfgang, MS CGO, Cancer, Bartella, Isabel, Fransen, Laura F C, Gutschow, Christian A, Bruns, Christiane J, van Berge Henegouwen, Mark L, Chaudry, M Asif, Cheong, Edward, Cuesta, Miguel A, Van Daele, Elke, Gisbertz, Suzanne S, van Hillegersberg, Richard, Hölscher, Arnulf, Mercer, Stuart, Moorthy, Krishna, Nafteux, Philippe, Nilsson, Magnus, Pattyn, Piet, Piessen, Guillaume, Räsanen, Jari, Rosman, Camiel, Ruurda, Jelle P, Schneider, Paul M, Sgromo, Bruno, Nieuwenhuijzen, Grard A, Luyer, Misha D P, and Schröder, Wolfgang

Published
2021

20. Distribution of lymph node metastases in esophageal carcinoma [TIGER study] : Study protocol of a multinational observational study

Author

Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., Gisbertz, Suzanne S., Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., and Gisbertz, Suzanne S.

Published
2019

21. Australian private emergency departments can assist ambulance services by taking public emergency patients during surge and disasters

Author

Walker, Katie, Stephenson, Michael, Dunlop, William, Cheong, Edward M, Ben-Meir, Michael, Walker, Katie, Stephenson, Michael, Dunlop, William, Cheong, Edward M, and Ben-Meir, Michael

Abstract

We describe a novel ambulance diversion programme, piloted in Victoria. This article discusses creating increased emergency capacity during surge or disasters by utilising private EDs, tested during a recent thunderstorm asthma disaster and an influenza epidemic. Public hospitals and EDs often run at or over capacity during normal operations. This leaves limited ability to manage surges in demand, resulting in suboptimal outcomes for patients, public ED staff and ambulance services. It is feasible to create surge capacity in private EDs for public ambulance patients. Other states could consider this option to help manage health disasters.

Published
2019

22. Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: study protocol of a multinational observational study

Author

Hagens, Eliza R. C., Henegouwen, Mark I. van Berge, van Sandick, Johanna W., Cuesta, Miguel A., van der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A. P., Rosman, Camiel, Scheepers, Joris J. G., Sosef, Meindert N., van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Rasanen, Jari, Nafteux, Philippe, Pattyn, Piet, Hoelscher, Arnulf H., Schroeder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, de Manzoni, Giovanni, Mattioli, Sandro, Roig Garcia, Josep, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin-ichi, Chen, Haiquan, Law, Simon Y. K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flavio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J. G. H. M., Hulshof, Maarten C. C. M., van Laarhoven, Hanneke W. M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G. W., Gisbertz, Suzanne S., Hagens, Eliza R. C., Henegouwen, Mark I. van Berge, van Sandick, Johanna W., Cuesta, Miguel A., van der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A. P., Rosman, Camiel, Scheepers, Joris J. G., Sosef, Meindert N., van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Rasanen, Jari, Nafteux, Philippe, Pattyn, Piet, Hoelscher, Arnulf H., Schroeder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, de Manzoni, Giovanni, Mattioli, Sandro, Roig Garcia, Josep, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin-ichi, Chen, Haiquan, Law, Simon Y. K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flavio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J. G. H. M., Hulshof, Maarten C. C. M., van Laarhoven, Hanneke W. M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G. W., and Gisbertz, Suzanne S.

Abstract

BackgroundAn important parameter for survival in patients with esophageal carcinoma is lymph node status. The distribution of lymph node metastases depends on tumor characteristics such as tumor location, histology, invasion depth, and on neoadjuvant treatment. The exact distribution is unknown. Neoadjuvant treatment and surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy has not been reached. The aim of this study is to determine the distribution of lymph node metastases in patients with resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed. This can be the foundation for a uniform worldwide staging system and establishment of the optimal surgical strategy for esophageal cancer patients.MethodsThe TIGER study is an international observational cohort study with 50 participating centers. Patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival.DiscussionThe TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatmen

Published
2019

23. Distribution of lymph node metastases in esophageal carcinoma [TIGER study] : Study protocol of a multinational observational study

Author

Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., Gisbertz, Suzanne S., Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., and Gisbertz, Suzanne S.

Published
2019

24. Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: Study protocol of a multinational observational study

Author

Divisie Beeld & Oncologie, Cancer, Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., Gisbertz, Suzanne S., Divisie Beeld & Oncologie, Cancer, Hagens, Eliza R.C., Van Berge Henegouwen, Mark I., Van Sandick, Johanna W., Cuesta, Miguel A., Van Der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A.P., Rosman, Camiel, Scheepers, Joris J.G., Sosef, Meindert N., Van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Räsänen, Jari, Nafteux, Philippe, Pattyn, Piet, Hölscher, Arnulf H., Schröder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, De Manzoni, Giovanni, Mattioli, Sandro, Garcia, Josep Roig, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin Ichi, Chen, Haiquan, Law, Simon Y.K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flávio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J.G.H.M., Hulshof, Maarten C.C.M., Van Laarhoven, Hanneke W.M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G.W., and Gisbertz, Suzanne S.

Published
2019

25. Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: study protocol of a multinational observational study

Author

Hagens, Eliza R. C., Henegouwen, Mark I. van Berge, van Sandick, Johanna W., Cuesta, Miguel A., van der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A. P., Rosman, Camiel, Scheepers, Joris J. G., Sosef, Meindert N., van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Rasanen, Jari, Nafteux, Philippe, Pattyn, Piet, Hoelscher, Arnulf H., Schroeder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, de Manzoni, Giovanni, Mattioli, Sandro, Roig Garcia, Josep, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin-ichi, Chen, Haiquan, Law, Simon Y. K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flavio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J. G. H. M., Hulshof, Maarten C. C. M., van Laarhoven, Hanneke W. M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G. W., Gisbertz, Suzanne S., Hagens, Eliza R. C., Henegouwen, Mark I. van Berge, van Sandick, Johanna W., Cuesta, Miguel A., van der Peet, Donald L., Heisterkamp, Joos, Nieuwenhuijzen, Grard A. P., Rosman, Camiel, Scheepers, Joris J. G., Sosef, Meindert N., van Hillegersberg, Richard, Lagarde, Sjoerd M., Nilsson, Magnus, Rasanen, Jari, Nafteux, Philippe, Pattyn, Piet, Hoelscher, Arnulf H., Schroeder, Wolfgang, Schneider, Paul M., Mariette, Christophe, Castoro, Carlo, Bonavina, Luigi, Rosati, Riccardo, de Manzoni, Giovanni, Mattioli, Sandro, Roig Garcia, Josep, Pera, Manuel, Griffin, Michael, Wilkerson, Paul, Chaudry, M. Asif, Sgromo, Bruno, Tucker, Olga, Cheong, Edward, Moorthy, Krishna, Walsh, Thomas N., Reynolds, John, Tachimori, Yuji, Inoue, Haruhiro, Matsubara, Hisahiro, Kosugi, Shin-ichi, Chen, Haiquan, Law, Simon Y. K., Pramesh, C. S., Puntambekar, Shailesh P., Murthy, Sudish, Linden, Philip, Hofstetter, Wayne L., Kuppusamy, Madhan K., Shen, K. Robert, Darling, Gail E., Sabino, Flavio D., Grimminger, Peter P., Meijer, Sybren L., Bergman, Jacques J. G. H. M., Hulshof, Maarten C. C. M., van Laarhoven, Hanneke W. M., Mearadji, Banafsche, Bennink, Roel J., Annema, Jouke T., Dijkgraaf, Marcel G. W., and Gisbertz, Suzanne S.

Abstract

BackgroundAn important parameter for survival in patients with esophageal carcinoma is lymph node status. The distribution of lymph node metastases depends on tumor characteristics such as tumor location, histology, invasion depth, and on neoadjuvant treatment. The exact distribution is unknown. Neoadjuvant treatment and surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy has not been reached. The aim of this study is to determine the distribution of lymph node metastases in patients with resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed. This can be the foundation for a uniform worldwide staging system and establishment of the optimal surgical strategy for esophageal cancer patients.MethodsThe TIGER study is an international observational cohort study with 50 participating centers. Patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival.DiscussionThe TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatmen

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results