Schizas, Dimitriοs

Abstract OBJECTIVES Oesophageal cancer oligometastasis is a state of limited systemic disease characterized by ˂5 metastases. Without surgery average survival is 4–12 months. We sought to estimate patient prognosis following the surgical resection of oligometastatic disease from oesophageal cancer. METHODS Eligible studies were identified through systematic search of PubMed and the Cochrane Library (end-of-search date: 20 November 2019). We estimated cumulative 1-, 3- and 5-year, as well as overall survival using bootstrap methodology with 1 000 000 repetitions per outcome. RESULTS We investigated six studies involving 420 patients who underwent metastasectomy for oligometastasis from oesophageal cancer. Adenocarcinoma [77.3%; 95% confidence interval (CI) 62.8–87.3] was the most prevalent histological type followed by squamous cell carcinoma (22.7%; 95% CI 12.7–37.2). Metastatic lesions were typically synchronous (91.5%; 95% CI 87.5–94.1). Overall, 73.5% (95% CI 67.5–78.6) of the patients underwent resection of the primary and metastatic tumours synchronously. Neoadjuvant chemoradiotherapy was utilized in the majority of the patients (66.7%; 95% CI 49.5–80.3) followed by neoadjuvant chemotherapy (33.3%; 95% CI 19.6–50.5). The mean overall survival was 24.5 months (95% CI 14.4–34.6). One-year survival was 88.3% (95% CI 85.6–90.8). Three-year survival and 5-year survival were 36.3% (95% CI 15.3–7.3) and 23.8% (95% CI 12.0–35.7), respectively. CONCLUSIONS Patients undergoing surgical resection of oesophageal oligometastasis survive for more than 24 months. Therefore, loco-regional control of oligometastatic disease appears to improve survival by at least 100%.

Literature discussing cardiac injuries in children is limited. Systematic search of PubMed identified 21 studies enrolling 1,062 pediatric patients who experienced cardiac trauma in the United States during the period 1961 to 2012. The predominant type of injury was blunt cardiac contusion affecting 59.7% (n = 634/1,062) of the study population. Motor vehicle crashes (53.5%, n = 391/731) were the leading cause of blunt cardiac trauma, while gunshot wounds (50%, n = 150/300) accounted for most penetrating injuries. Overall mortality rate was 35.2% (n = 374/1,062).