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
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.
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
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
University Hospital of Lille
All authors have declared no conflicts of interest.