ArticleAnnals of surgical oncology2020
Margin Positivity in Resectable Esophageal Cancer: Are there Modifiable Risk Factors?
Article in Annals of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 25 citations in OpenAlex.
- Does robotic-assisted esophagectomy improve outcomes compared to other techniques? An NCDB analysis of access and disparities.Surgical endoscopy · 2026Article
- Perioperative management of non-metastatic gastroesophageal cancer in a Philippine university hospital: a 10-year experience.World journal of surgical oncology · 2026Article
- Using Pathomics-Based Model for Predicting Positive Surgical Margins in Patients with Esophageal Squamous Cell Carcinoma: A Comparative Study of Decision Tree and Nomogram.International journal of general medicine · 2024Article
- Novel anti-CEA affibody for rapid tumor-targeting and molecular imaging diagnosis in mice bearing gastrointestinal cancer cell lines.Frontiers in microbiology · 2024Article
- Application of near-infrared fluorescence imaging in theranostics of gastrointestinal tumors.Gastroenterology report · 2023Review
- Clinical impact of remnant lymphatic invasion on the recurrence of esophageal squamous cell carcinoma after esophagectomy with neoadjuvant chemotherapy.Oncology letters · 2022Article
- Long-term outcomes of endoscopic mucosal resection for early-stage esophageal adenocarcinoma.Surgical endoscopy · 2022Article
- Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis.BMC gastroenterology · 2021Article
- Outcomes of robotic esophagectomies for esophageal cancer by hospital volume: an analysis of the national cancer database.Surgical endoscopy · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPatients with esophageal cancer have poor overall survival, with positive resection margins worsening survival. Margin positivity rates are used as quality measures in other malignancies, but modifiable risk factors are necessary to develop actionable targets for improvement. Our objectives were to (1) evaluate trends in esophageal cancer margin positivity, and (2) identify modifiable patient/hospital factors associated with margin positivity.
methodsPatients who underwent esophagectomy from 2004 to 2015 were identified from the National Cancer Database. Trends in margin positivity by time and hospital volume were evaluated using Cochrane-Armitage tests. Associations between patient/hospital factors and margin positivity were assessed by multivariable logistic regression.
resultsAmong 29,706 patients who underwent esophagectomy for cancer, 9.37% had positive margins. Margin positivity rates decreased over time (10.62% in 2004 to 8.61% in 2015; p < 0.001). Older patients (≥ 75 years) were more likely to have positive margins [odds ratio (OR) 2.04, 95% confidence interval (CI) 1.42-2.92], as were patients with a Charlson-Deyo Index ≥ 3 (OR 1.84, 95% CI 1.08-3.12). Patients who received neoadjuvant therapy were less likely to have positive margins (OR 0.37, 95% CI 0.29-0.47), while laparoscopic surgical approach was associated with increased margin positivity (OR 1.70, 95% CI 1.40-2.06). As the hospital annual esophagectomy volume increased, margin positivity rates decreased (7.76% in the fourth quartile vs. 11.39% in the first quartile; OR 0.70, 95% CI 0.49-0.99).
conclusionsUse of neoadjuvant therapy, surgical approach, and hospital volume are modifiable risk factors for margin positivity in esophageal cancer. These factors should be considered in treatment planning, and margin positivity rates could be considered as a quality measure in esophageal cancer.
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