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J Thorac Cardiovasc Surg 2009;137:253-254
© 2009 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the Editor:

Steven R. DeMeester, Dr.

Department of Surgery, University of Southern California, Los Angeles, Calif

The first 20% of the full text of this article appears below.

We appreciate the questions and comments by Drs Chang and McAnena in regards to our study, which demonstrated significantly improved survival after neoadjuvant therapy with an en bloc esophagectomy compared with a transhiatal resection.1Go Regarding the nonrandomized study by Morgan et al that failed to show a difference between a transthoracic and transhiatal resection after neoadjuvant therapy, there are several points that bear mentioning.2Go First, in contrast to our study, their population was mixed adenocarcinoma and squamous cell cancer. Furthermore, although we reported a significantly greater number of nodes resected with the en bloc resection (median 29.5 versus 19 in the transhiatal group), Morgan et al inexplicably reported a median of 13 resected nodes with each procedure. Last, although our results with transhiatal resection mirror reports from other centers, their results were unusual. They reported a local recurrence rate of 6% and 5-year survival of 53% after neoadjuvant therapy and transhiatal resection compared with 17% and 22% in our study and 19% and 20%, respectively, in the randomized University of Michigan trial.3Go These . . . [Full Text of this Article]






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