Evidence map›Paper›PMID 39627639›Full record

ArticleAnnals of surgical oncology2025

Outcomes of Salvage Surgery for Esophageal Carcinoma: A Nationwide Cohort Study from the Dutch Upper GI Cancer Audit.

Maurits R Visser, Daan M Voeten, Suzanne S Gisbertz, Jelle P Ruurda, Richard van Hillegersberg, Mark I van Berge Henegouwen, Dutch Upper Gastrointestinal Cancer Audit (DUCA) Group

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maurits R VisserDepartment of Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Daan M VoetenDepartment of Surgery, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.
Suzanne S GisbertzCancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands.
Jelle P RuurdaDepartment of Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Richard van HillegersbergDepartment of Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Mark I van Berge HenegouwenCancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands. m.i.vanbergehenegouwen@amsterdamumc.nl.ORCID http://orcid.org/0000-0001-8689-3134
Dutch Upper Gastrointestinal Cancer Audit (DUCA) Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSalvage esophagectomy is more complex and associated with higher postoperative morbidity and mortality than standard resection. This study aimed to investigate short-term outcomes and the influence of hospital volume on these outcomes of salvage surgery for esophageal cancer.

methodsThe study enrolled all patients undergoing esophagectomy for esophageal cancer registered in the Dutch Upper Gastrointestinal Cancer Audit (DUCA) between 2012 and 2022. The patients were classified as salvage or non-salvage by registering surgeons. Salvage surgery is defined in the DUCA as surgery after definitive chemoradiotherapy. Postoperative mortality (30-day/in-hospital) and morbidity were compared between the salvage and non-salvage patients using multilevel logistic regression analyses. Hospital variation in the use of salvage esophagectomy was investigated using funnel plots. The influence of hospital volume (≤ 40 to > 40 cases) and salvage volume (< 6 to ≥ 6 cases) on outcomes for salvage patients were investigated. Using backward elimination, relevant baseline characteristics influencing salvage outcomes were identified.

resultsBetween 2012 and 2022, 7749 patients underwent esophagectomy, 251 (3%) of whom underwent salvage resection, varying from 0 to 8% between centers. Severe complications (43% vs 28%; odds ratio [OR], 1.81; 95 % confidence interval [CI], 1.40-2.34) and 30-day/in-hospital mortality (11% vs 3%; OR, 3.65; 95% CI, 2.38-5.61) were higher after salvage surgery than after non-salvage surgery. Salvage patients treated in high-volume centers had a lower risk of 30-day/in-hospital mortality than those treated in low-volume centers (9% vs 19%; OR, 0.42; 95% CI, 0.18-0.99), with no relation between salvage volume and outcome. Male sex, older age (> 75 years), and squamous cell carcinoma were associated with worse short-term outcomes of salvage surgery.

conclusionsSalvage surgery is associated with worse short-term outcomes than non-salvage esophagectomy. Outcomes after salvage surgery were favorable in high-volume esophagectomy centers.

Indexed as

Esophageal NeoplasmsEsophagectomyPostoperative ComplicationsSalvage TherapyAgedCohort StudiesFemaleFollow-Up StudiesHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHumansMaleMiddle AgedNetherlandsPrognosisComplicationsEsophageal carcinomaEsophagectomySalvage esophagectomySurgery

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.