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

Date

08 Oct 2016

Session

Poster Display

Presenters

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

Author affiliations

  • 1 Dpt Of Digestive And Oncological Surgery, Lille University Hospital, France, 59037 - Lille/FR
  • 2 Dpt Of Pathology, Lille University Hospital, France, 59037 - Lille/FR
  • 3 Dpt Of Radiology, Lille University Hospital, France, 59037 - Lille/FR
  • 4 Service Cancérologie Digestive, Centre Oscar Lambret, Lille/FR
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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.

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