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Background <p>High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.</p> Methods <p>Data from all patients undergoing EGs-ITA from January 2013 to June 2023 were collected from an institutional database and retrospectively analyzed. Additionally, data on the volume of all MOSs performed in the same 10-year period were retrieved.</p> Results <p>This study included 32 patients, averaging three EGs-ITA performed annually. The anastomotic leak rate was 6.2%. The median hospital stay was 12 days, and 30- and 90-day mortality rates were 3.1% and 6.2%, respectively. The mean harvested lymph nodes were 26.3 ± 10.2. Re-admission and locoregional recurrence occurred in 6.2% and 9.3% of patients, respectively. During the study period, the surgical team managed over 400 MOSs annually.</p> Conclusion <p>Exposure to high volume and broad range of MOSs appears beneficial for achieving favorable outcomes in esophagogastric junction and distal esophageal cancer surgeries, even in centers with lower volumes of these specific procedures. This finding underscores the potential for excellent surgical results in settings with substantial overall volumes in major oncologic procedures, as an alternative to high-volume specialization in a single surgery type.</p>

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Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月2日

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  • Simone Guadagni,
  • Annalisa Comandatore,
  • Niccolò Furbetta,
  • Gregorio Di Franco,
  • Bianca Bechini,
  • Filippo Vagelli,
  • Niccolò Ramacciotti,
  • Raffaele Gaeta,
  • Luca Emanuele Pollina,
  • Matteo Palmeri,
  • Giulio Di Candio,
  • Luca Morelli

摘要

Background

High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.

Methods

Data from all patients undergoing EGs-ITA from January 2013 to June 2023 were collected from an institutional database and retrospectively analyzed. Additionally, data on the volume of all MOSs performed in the same 10-year period were retrieved.

Results

This study included 32 patients, averaging three EGs-ITA performed annually. The anastomotic leak rate was 6.2%. The median hospital stay was 12 days, and 30- and 90-day mortality rates were 3.1% and 6.2%, respectively. The mean harvested lymph nodes were 26.3 ± 10.2. Re-admission and locoregional recurrence occurred in 6.2% and 9.3% of patients, respectively. During the study period, the surgical team managed over 400 MOSs annually.

Conclusion

Exposure to high volume and broad range of MOSs appears beneficial for achieving favorable outcomes in esophagogastric junction and distal esophageal cancer surgeries, even in centers with lower volumes of these specific procedures. This finding underscores the potential for excellent surgical results in settings with substantial overall volumes in major oncologic procedures, as an alternative to high-volume specialization in a single surgery type.