Galán M, Farran L, Aliste L, Hormigo G, Aranda H, Bettonica C, Boladeras A M, Botargues J M, Calvo M, Creus G, De Lama M E, Gornals J B, Mast R, Miró M, Paúles M J, Robles J, Virgili N, Borràs J M
Multidisciplinary Oesophagogastric Tumour Committee and Unit, Catalonian Institute of Oncology, IDIBELL, Barcelona, Spain,
Clin Transl Oncol. 2015 Mar;17(3):247-56. doi: 10.1007/s12094-014-1221-7. Epub 2014 Dec 18.
Modern management of Oesophageal and oesophagogastric junction (OGJ) cancers requires a multidisciplinary approach, which was implemented at our health centre in 2005. This study aimed to assess the impact of this change on clinical outcomes.
A retrospective cohort study was conducted, covering all patients treated for oesophageal and OGJ cancer at the cancer centre established by the Bellvitge University Hospital and Catalonian Institute of Oncology, over two time periods, i.e. 2000-2004 and 2005-2008. Descriptive and multivariate analyses were performed using survival at 1 and 3 years as dependent variables.
Between 1 January 2000 and 31 December 2008, 586 patients were included. Number of patients with unknown stage at diagnosis was significantly reduced. Preoperative strategies at the oesophageal location clearly increased in the recent period. A multidisciplinary approach resulted in a significant reduction in surgical mortality (11.8 vs. 2 %) in the period 2005-2008. Analysis restricted to patients undergoing surgery with curative intent indicated a significant increase in 1- and 3-year survival in the latter period (68.4 vs. 89.8 and 38.2 vs. 57.1 %, respectively). Multivariate analysis showed that variables associated with improved survival were: age; tumour stage; radical intent of treatment (surgery and radical combined chemoradiotherapy); and therapeutic strategy.
Better selection of patients for therapy together with improved staging resulted in a significant improvement in 1- and 3-year survival in cases undergoing surgery with curative intent. These changes would support the adoption of a multidisciplinary approach to clinical decision-making in cases of oesophageal and OGJ cancer.
食管癌和食管胃交界（OGJ）癌的现代管理需要多学科方法，我们的健康中心于2005年实施了该方法。本研究旨在评估这一变化对临床结果的影响。
进行了一项回顾性队列研究，涵盖在贝尔维奇大学医院和加泰罗尼亚肿瘤研究所设立的癌症中心接受食管癌和OGJ癌治疗的所有患者，分为两个时间段，即2000 - 2004年和2005 - 2008年。以1年和3年生存率作为因变量进行描述性和多变量分析。
2000年1月1日至2008年12月31日期间，共纳入586例患者。诊断时分期不明的患者数量显著减少。近期食管部位的术前策略明显增加。多学科方法使2005 - 2008年期间手术死亡率显著降低（11.8%对2%）。仅限于接受根治性手术的患者的分析表明，后期1年和3年生存率显著提高（分别为68.4%对89.8%和38.2%对57.1%）。多变量分析显示，与生存率提高相关的变量有：年龄；肿瘤分期；治疗的根治意图（手术和根治性联合放化疗）；以及治疗策略。
更好地选择治疗患者并改善分期，使接受根治性手术的患者1年和3年生存率显著提高。这些变化将支持在食管癌和OGJ癌病例的临床决策中采用多学科方法。
