ArticleThe Annals of thoracic surgery2017
Adhering to Quality Measures in Esophagectomy Is Associated With Improved Survival in All Stages of Esophageal Cancer.
Article in The Annals of thoracic surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Impact of Hospital Volume on Postoperative Outcomes for Esophagectomy and Gastrectomy: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2026Pooled it
- Quality Performance Indicators for the Surgical Management of Oesophageal Cancer: A Systematic Literature Review.World journal of surgery · 2023Pooled it
- Positive circumferential resection margin in locally advanced esophageal cancer: an updated systematic review and meta-analysis.Updates in surgery · 2022Pooled it
- Observational
- Textbook outcome for esophageal cancer surgery: an international consensus-based update of a quality measure.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2021Article
- Adherence to quality measures improves survival in esophageal cancer in a retrospective cohort study of the national cancer database from 2004 to 2016.Journal of thoracic disease · 2020Article
- Adequate Lymphadenectomy as a Quality Measure in Esophageal Cancer: Is there an Association with Treatment Approach?Annals of surgical oncology · 2020Article
- Margin Positivity in Resectable Esophageal Cancer: Are there Modifiable Risk Factors?Annals of surgical oncology · 2020Article
- Optimal Therapy in Locally Advanced Esophageal Cancer: a National Cancer Database Analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Oncologic Quality Indicators in Thoracic Surgery.Thoracic surgery clinics · 2017Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundQuality measures for patients with early and locally advanced esophageal cancer undergoing esophagectomy have been made by national organizations. The rate of adherence to these measures as well as their association with overall survival are unknown.
methodsEsophagectomy patients were abstracted from the National Cancer Database. Because neoadjuvant status was available since 2006, the analysis of locally advanced patients began at this time point. Selected measures included: R0 resection, evaluation of 15 or more lymph nodes, and induction therapy for locally advanced tumors. Multivariate models identified variables associated with achieving quality measures. A Cox proportional hazards model evaluated factors associated with mortality.
resultsFrom 1998 to 2012, 4,908 of 16,040 (30.6%) early-stage esophageal cancer patients (clinical T1A to T2N0 <2cm, well-differentiated) underwent esophagectomy. Of 4,672 patients 4,518 (96.7%) achieved R0 resection and 1,395 of 4,686 (29.8%) had 15 or more lymph nodes sampled. High-volume center type (>20 esophagectomies/year) was independently associated with meeting both measures (odds ratio [OR] 2.2, 95% confidence interval [CI]: 1.9 to 2.5). From 2006 to 2012, 7,747 of 20,437 (37.9%) locally advanced patients (clinical Stage IIB to IIIB) received esophagectomy. Of 6,966 patients 5,977 (85.8%) received induction therapy, 6,394 (91.8%) had R0 resection, and 2,852 (40.9%) had 15 or more lymph nodes sampled. High-volume center type was, again, associated with increased likelihood of meeting all quality measures (OR 2.17, 95% CI: 1.92 to 2.46). Meeting all quality measures was associated with the largest decrease in mortality for both early-stage (hazard ratio [HR] 0.27, 95% CI: 0.18 to 0.39) and locally advanced (HR 0.54, 95% CI: 0.40 to 0.73) esophageal cancer patients.
conclusionsAdherence to recommended quality measures is independently associated with improved overall survival in both early and locally advanced stages of esophageal cancer. Currently, few patients are receiving care in accordance with these recommendations.
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