Related Experiment Video
Updated: Jul 15, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Circumferential resection margin and early recurrence after neoadjuvant-treated hybrid ivor lewis esophagectomy: a
Muhammad Hammad Ur Rehman1, Mariam Asad1, Mehrub Munawar1
1Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, Pakistan.
Background:
The prognostic value of circumferential resection margin (CRM) width after neoadjuvant-treated esophagectomy remains uncertain.
Objective:
To assess whether CRM distance predicts early (12-month) locoregional recurrence (LRR) following hybrid Ivor-Lewis esophagectomy.
Design/Setting:
Retrospective observational cohort at a tertiary cancer center, April 2023-October 2024.
Participants:
Consecutive adults who underwent two-stage (hybrid) esophagectomy for malignancy; emergencies and abandoned resections excluded.
Exposure:
Pathologic CRM measured in millimeters, analyzed continuously and by RCPath thresholds (≤ 1 mm vs. > 1 mm).
Main Outcomes:
Primary-12-month locoregional recurrence (LRR). Secondary-any recurrence and recurrence-free survival (RFS).
Results:
Sixty-three resections were analyzed. CRM was measurable in 45 (71.4%). Median CRM was 2.0 mm (IQR 1.0-3.0). Six patients (9.5%) developed recurrence within 12 months-five locoregional and one distant. One of twenty-nine pathological complete responders (pCR, 3.4%) recurred. Univariable analysis did not demonstrate a significant association between CRM distance and early recurrence. Kaplan-Meier analysis showed no statistically significant difference in recurrence-free survival between CRM categories.
Conclusions:
Early recurrence occurred in 9.5% of patients, predominantly locoregional. CRM distance, whether analyzed continuously or using RCPath thresholds, was not associated with early recurrence. These findings suggest that, within this single-center cohort, early relapse may reflect underlying tumor biology rather than marginal radial clearance, although results should be interpreted with caution given limited event numbers.
