Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Esophageal cancer rates climb with obesity; U-M study finds esophagectomy safe in obese patients

31.01.2007
The rapidly climbing obesity rates in the United States have created a higher risk of esophageal cancer linked to reflux disease. And this has some surgeons wondering if a currently popular procedure to remove the esophagus is as safe in obese patients.

According to a new study at the University of Michigan Health System, obese patients who underwent a procedure called transhiatal esophagectomy primarily for esophageal cancer had outcomes similar to their lean counterparts.

"The type of patient who currently develops esophageal cancer has changed dramatically in the last 20 years. Esophageal cancer used to be primarily squamous cell carcinoma found in people who drank alcohol and smoked excessively. In association with the horrendous epidemic of obesity in this country, we have seen a 350 percent increase of adenocarcinoma over the last 30 years. This is related to more gastroesophageal relux and Barrett's esophagus in these patients," says Mark Orringer, M.D., John Alexander Distinguished Professor of Surgery at the U-M Medical School.

Orringer and lead study author Christopher Scipione, a U-M medical student, will present the study results Tuesday, Jan. 30, at the Society of Thoracic Surgeons 43rd annual meeting in San Diego.

Adenocarcinoma of the esophagus is often the result of chronic reflux disease. When acid continuously backs up into the esophagus, it wears down the natural lining. This can cause a condition called Barrett's esophagus in which the body replaces the normal esophageal lining with one similar to that found in the intestines. People who develop Barrett's are at a higher risk of developing adenocarcinoma.

Transhiatal esophagectomy, or THE, is an operation in which most of the esophagus is removed without the need to open the chest, and swallowing is restored by pulling the stomach to the neck and connecting it there to the remaining esophagus. THE is used to treat esophageal cancer and Barrett's esophagus with severe precancerous changes. It was originally developed at the University of Michigan as a surgical alternative to removing the esophagus by going through the chest, a much more difficult operation for the patient.

The researchers sought to determine if THE is a safe procedure for the growing number of obese patients requiring esophageal surgery. They pulled the records of 133 profoundly obese patients who had this surgery at U-M between 1977 and 2006. Profound obesity was defined as a body mass index of 35 or more. Those 133 patients were matched to a randomly selected control group of non-obese patients undergoing the same procedure. Both groups were matched for factors including gender, age, year of operation and pre-existing medical conditions.

After comparing measures such as hospital length of stay, infection and mortality, the researchers found both groups had comparable outcomes. This suggests the THE procedure is safe to perform in obese patients. The study authors stress, however, that the results may be influenced by the high volume of patients U-M surgeons see for this procedure. U-M surgeons perform 120 to 150 transhiatal esophagectomies each year and have completed more than 2,000 of these procedures in total. Because the procedure in obese patients is more demanding on surgeons, the results may not be the same in hospitals that see relatively few patients in need of an esophagectomy.

"Profoundly obese patients undergoing a THE at a high-volume center can have surprisingly and acceptably low morbidity and mortality rates, similar to those of non-obese individuals matched for co-morbidities," says Orringer, head of the U-M Section of Thoracic Surgery and co-director of the Thoracic Oncology Program at the U-M Comprehensive Cancer Center.

Currently about 85 percent of esophageal cancers removed in this country are adenocarcinomas, most related to obesity and reflux disease, and 15 percent are squamous cell carcinomas, typically due to smoking or alcohol consumption. Two decades ago, those numbers were reversed.

"Reflux is an extraordinarily common problem now, and it's because we're a fat society. If heartburn is persistent or chronic, patients should have a thorough exam and endoscopy to see if they have developed Barrett's esophagus, which carries an increased risk of cancer and signals the need for close surveillance with periodic endoscopies and biopsies," Orringer says.

Nicole Fawcett | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>