657P - Esophageal adenocarcinoma: Impact of a large hiatal hernia on outcomes after surgery

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Oesophageal Cancer
Presenter Caroline Gronnier
Citation Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371
Authors C. Gronnier1, A. Gandon1, F. Renaud2, P. Borde3, M. Vanderbeken1, F. Hec1, G. Piessen1, A. Adenis4, X. Mirabel4, C. Mariette1
  • 1Dpt Of Digestive And Oncological Surgery, Lille University Hospital, France, 59037 - Lille/FR
  • 2Dpt Of Pathology, Lille University Hospital, France, 59037 - Lille/FR
  • 3Dpt Of Radiology, Lille University Hospital, France, 59037 - Lille/FR
  • 4Service Cancérologie Digestive, Centre Oscar Lambret, Lille/FR

Abstract

Background

Hiatal hernia (HH) is a risk factor for esophageal and junctional adenocarcinoma (EGJA). Its impact on the outcomes after EGJA surgery is unknown. Objectives were to evaluate complete tumor resection rate (primary objective), 30-day postoperative outcomes and survival (secondary objectives) in patients with a HH ≥ 5cm (HH group) compared to those who did not have a HH or presented with a HH 

Methods

Among 367 patients who underwent surgery for EGJA, a HH was searched for on CT scan and barium swallow, with comparison between the HH (n = 42) and control (n = 325) groups.

Results

In the HH group, EGJAs exhibited higher rates of pN3 stages (28.5% vs. 10.1%, P = 0.002), of incomplete resection (50.0% vs. 4.0%, P 

Conclusions

For the first time, we showed that a HH ≥5cm is associated with a poor prognosis in patients who had surgery for EGJA, linked to greater incomplete resection and lymph node involvement. Neoadjuvant radiotherapy was associated with a significant toxicity in patients with a HH ≥5cm.

Clinical trial identification


Legal entity responsible for the study

None

Funding

University Hospital of Lille

Disclosure

All authors have declared no conflicts of interest.