Imperial College London
Alternate

ProfessorGeorgeHanna

Faculty of Medicine, Department of Surgery & Cancer

Head of Department of Surgery and Cancer
 
 
 
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Contact

 

+44 (0)20 7594 3396g.hanna

 
 
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Assistant

 

Ms Aoibheann Byrne +44 (0)20 7594 3396

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Knight:2020:10.1016/j.ejso.2020.07.003,
author = {Knight, WRC and McEwen, R and Byrne, BE and Habib, W and Bott, R and Zylstra, J and Mahadeva, U and Gossage, JA and Fitzgerald, RC and Noorani, A and Edwards, PAW and Grehan, N and Nutzinger, B and Hughes, C and Fidziukiewicz, E and MacRae, S and Northrop, A and Contino, G and Li, X and de, la Rue R and Katz-Summercorn, A and Abbas, S and Loureda, D and O'Donovan, M and Miremadi, A and Malhotra, S and Tripathi, M and Tavaré, S and Lynch, AG and Eldridge, M and Secrier, M and Devonshire, G and Perner, J and Jammula, S and Davies, J and Crichton, C and Carroll, N and Safranek, P and Hindmarsh, A and Sujendran, V and Hayes, SJ and Ang, Y and Sharrocks, A and Preston, SR and Oakes, S and Bagwan, I and Save, V and Skipworth, RJE and Hupp, TR and O'Neill, JR and Tucker, O and Beggs, A and Taniere, P and Puig, S and Underwood, TJ and Walker, RC and Grace, BL and Barr, H and Shepherd, N and Old, O and Lagergren, J and Davies, A and Chang, F and Goh, V and Ciccarelli, FD and Sanders, G and Berr},
doi = {10.1016/j.ejso.2020.07.003},
journal = {European Journal of Surgical Oncology},
title = {Endoscopic tumour morphology impacts survival in adenocarcinoma of the oesophagus},
url = {http://dx.doi.org/10.1016/j.ejso.2020.07.003},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundPrognostication in oesophageal cancer on the basis of preoperative variables is challenging. Many of the accepted predictors of survival are only derived after surgical treatment and may be influenced by neoadjuvant therapy. This study aims to explore the relationship between pre-treatment endoscopic tumour morphology and postoperative survival.MethodsPatients with endoscopic descriptions of tumours were identified from the prospectively managed databases including the OCCAMS database. Tumours were classified as exophytic, ulcerating or stenosing. Kaplan Meier survival analysis and multivariable Cox regression analyses were performed to determine hazard ratios (HR) with 95% confidence intervals.Results262 patients with oesophageal adenocarcinoma undergoing potentially curative resection were pooled from St Thomas’ Hospital (161) and the OCCAMS database (101). There were 70 ulcerating, 114 exophytic and 78 stenosing oesophageal adenocarcinomas. Initial tumour staging was similar across all groups (T3/4 tumours 71.4%, 70.2%, 74.4%). Median survival was 55 months, 51 months and 36 months respectively (p<0.001). Rates of lymphovascular invasion (P=0.0176), pathological nodal status (P=0.0195) and pathological T stage (P=0.0007) increased from ulcerating to exophytic to stenosing lesions. Resection margin positivity was 21.4% in ulcerating tumours compared to 54% in stenosing tumours (p<0.001). When compared to stenosing lesions, exophytic and ulcerating lesions demonstrated a significant survival advantage on multivariable analysis (HR 0.56 95% CI 0.31–0.93, HR 0.42 95% CI 0.21–0.82).ConclusionThis study demonstrates that endoscopic morphology may be an important pre-treatment prognostic factor in oesophageal cancer. Ulcerating, exophytic and stenosing tumours may represent different pathological processes and tumour biology.
AU  - Knight,WRC
AU  - McEwen,R
AU  - Byrne,BE
AU  - Habib,W
AU  - Bott,R
AU  - Zylstra,J
AU  - Mahadeva,U
AU  - Gossage,JA
AU  - Fitzgerald,RC
AU  - Noorani,A
AU  - Edwards,PAW
AU  - Grehan,N
AU  - Nutzinger,B
AU  - Hughes,C
AU  - Fidziukiewicz,E
AU  - MacRae,S
AU  - Northrop,A
AU  - Contino,G
AU  - Li,X
AU  - de,la Rue R
AU  - Katz-Summercorn,A
AU  - Abbas,S
AU  - Loureda,D
AU  - O'Donovan,M
AU  - Miremadi,A
AU  - Malhotra,S
AU  - Tripathi,M
AU  - Tavaré,S
AU  - Lynch,AG
AU  - Eldridge,M
AU  - Secrier,M
AU  - Devonshire,G
AU  - Perner,J
AU  - Jammula,S
AU  - Davies,J
AU  - Crichton,C
AU  - Carroll,N
AU  - Safranek,P
AU  - Hindmarsh,A
AU  - Sujendran,V
AU  - Hayes,SJ
AU  - Ang,Y
AU  - Sharrocks,A
AU  - Preston,SR
AU  - Oakes,S
AU  - Bagwan,I
AU  - Save,V
AU  - Skipworth,RJE
AU  - Hupp,TR
AU  - O'Neill,JR
AU  - Tucker,O
AU  - Beggs,A
AU  - Taniere,P
AU  - Puig,S
AU  - Underwood,TJ
AU  - Walker,RC
AU  - Grace,BL
AU  - Barr,H
AU  - Shepherd,N
AU  - Old,O
AU  - Lagergren,J
AU  - Davies,A
AU  - Chang,F
AU  - Goh,V
AU  - Ciccarelli,FD
AU  - Sanders,G
AU  - Berrisford,R
AU  - Harden,C
AU  - Lewis,M
AU  - Cheong,E
AU  - Kumar,B
AU  - Parsons,SL
AU  - Soomro,I
AU  - Kaye,P
AU  - Saunders,J
AU  - Lovat,L
AU  - Haidry,R
AU  - Igali,L
AU  - Scott,M
AU  - Sothi,S
AU  - Suortamo,S
AU  - Lishman,S
AU  - Hanna,GB
AU  - Moorthy,K
AU  - Peters,CJ
AU  - Grabowska,A
AU  - Turkington,R
AU  - McManus,D
AU  - Coleman,H
AU  - Khoo,D
AU  - Fickling,W
DO  - 10.1016/j.ejso.2020.07.003
PY  - 2020///
SN  - 0748-7983
TI  - Endoscopic tumour morphology impacts survival in adenocarcinoma of the oesophagus
T2  - European Journal of Surgical Oncology
UR  - http://dx.doi.org/10.1016/j.ejso.2020.07.003
UR  - https://www.sciencedirect.com/science/article/pii/S074879832030576X?via%3Dihub
ER  -
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