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. 2000 Aug;232(2):225-32.
doi: 10.1097/00000658-200008000-00013.

Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years

N Ando  1 , S Ozawa, Y Kitagawa, Y Shinozawa, M Kitajima
Affiliations

Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years

N Ando et al. Ann Surg. 2000 Aug.

Abstract

Objective: To document the clinicopathologic characteristics and survival of patients undergoing esophagectomy for squamous carcinoma of the thoracic esophagus, and to examine the factors contributing to improvements in outcome noted in patients with advanced carcinoma.

Summary background data: Japanese and some Western surgeons recently have reported that radical esophagectomy with extensive lymphadenectomy conferred a survival advantage to patients with esophageal carcinoma. The factors contributing to this improvement in results have not been well defined.

Methods: From 1981 to 1995, 419 patients with carcinoma of the thoracic esophagus underwent esophagectomy at the Keio University Hospital. The clinicopathologic characteristics and survival of patients treated between 1981 and 1987 were compared with those of patients treated between 1988 and 1995. Multivariate analysis using the Cox regression model was carried out to evaluate the impact of 15 variables on survival of patients with p stage IIa to IV disease. Several variables related to prognosis were examined to identify differences between the two time periods.

Results: The 5-year survival rate for all patients was 40.0%. The 5-year survival rate was 17.7% for p stage IIa to IV patients treated during the earlier period and 37.6% for those treated during the latter period. The Cox regression model revealed seven variables to be important prognostic factors. Of these seven, three (severity of postoperative complications, degree of residual tumor, and number of dissected mediastinal nodes) were found to be significantly different between the earlier and latter periods.

Conclusions: The survival of patients undergoing surgery for advanced carcinoma (p stage IIa to IV) of the thoracic esophagus has improved during the past 15 years. The authors' data suggest that this improvement is due mainly to advances in surgical technique and perioperative management.

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Figures

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Figure 1. Incidence of lymph node metastases according to the location of the tumor.
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Figure 2. Overall survival curve of all patients who underwent esophagectomy between 1981 and 1995.
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Figure 3. Survival curves according to the location of the main lesion.
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Figure 4. Survival curves according to the depth of tumor invasion (T1a vs. T1b, P = .0009; T1b vs. T2, P < .0001; T1b vs. T3, P < .0001; T3 vs. T4, P < .0001).
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Figure 5. Survival curves according to presence or absence of lymph node metastasis (P < .0001).
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Figure 6. Survival curves according to TNM p stage (I vs. IIa, P < .0001; I vs. IIb, P < .0001; IIa vs. III, P < .0001; IIb vs. III, P < .0001).
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Figure 7. Survival curves of p stage IIa to IV patients according to the date of surgery (P < .001).
See this image and copyright information in PMC

References

    1. Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg 1994; 220: 364–373. - PMC - PubMed
    1. International Union Against Cancer. TNM Supplement 1993. New York: Springer-Verlag; 1993.
    1. Ando N, Shinozawa Y, Ikehata Y, et al. Postoperative nutritional status in patients with esophageal carcinoma. In: Ferguson MK, Little AG, Skinner DB, ed. Diseases of the Esophagus. New York: Futra Publishing; 1990: 261–269.
    1. Goseki N, Koike M, Yoshida M. Histopathologic characteristics of early-stage esophageal carcinoma. A comparative study with gastric carcinoma. Cancer 1992; 69: 1088–1093. - PubMed
    1. Iizuka T, Ide H, Kakegawa T, et al. Preoperative radioactive therapy for esophageal carcinoma. Randomized evaluation trial in eight institutions. Chest 1988; 93: 1054–1058. - PubMed