[100 consecutive cases of surgical esophagus-cardia carcinoma]

Abstract

100 esophagectomies were performed at the Waid Hospital in Zürich between 1981-1988. 55 patients underwent blunt esophagectomy without thoracotomy, 34 abdomino-thoracic resection with intrathoracic anastomosis, and 11 abdomino-thoracic resection with lymphadenectomy and cervical anastomosis. In 80% the tumor had spread through the esophageal wall or there were already regional lymph node metastases. Adenocarcinoma was found in 2/3 of the patients and epidermoid carcinoma in 1/3. 30-day mortality was 5%. The actuarial 5-year survival rate is 14%. Average hospital stay was 30 days. Blunt esophagectomy was mainly performed in older patients with tumor localization in the lower third. Abdomino-thoracic resection with cervical anastomosis was preferred for younger patients with tumor localization in the middle third. Surgical resection is the only curative therapy in esophageal cancer, but due to the often advanced tumor stage it is often only of palliative character.