Surgical treatment of esophageal carcinoma with curative intent: analysis of a single center experience

• Published in: Journal of cardiothoracic surgery Vol. 8; no. 1; p. 52
• Main Authors: De Giacomo, Tiziano, Trentino, Paolo, Venuta, Federico, Tsagkaropoulos, Socratis, Berloco, Pasquale Bartolomeo, Diso, Daniele, Francioni, Federico
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19-03-2013; BioMed Central
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Analysis; Analysis of Variance; Cancer; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Care and treatment; Chemotherapy; Esophageal cancer; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagectomy; Female; Health aspects; Humans; Information management; Kaplan-Meier Estimate; Male; Middle Aged; Mortality; Radiotherapy; Randomized Controlled Trials as Topic; Retrospective Studies; Squamous cell carcinoma
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/1749-8090-8-52

We retrospectively reviewed our series of 76 patients who underwent esophagectomy, with curative intent, for esophageal carcinoma over the last 10 years.
The mean age was 60 years ranging between 46 to 76 years. Fifty-seven patients had a squamous cell carcinoma and 19 patients had an adenocarcinoma. In 15 cases induction therapy was accomplished prior to surgery. A narrow gastric tube was used to restore continuity in 74 patients (97.3%). Medical records were reviewed and data analysis was performed.
Peri-operative mortality was 2.6%. Overall survival at 1, 3 and 5 years was 85,5%, 67,7% and 52,7%, respectively, with no significant difference between the squamous cell disease group and the adenocarcinoma group. Although T factor and stage at the time of surgery influenced overall survival, the presence of nodal metastasis had the major impact on survival as confirmed by univariate and multivariate analysis with a 5 year survival rate of 32% regardless of the use or not of adjuvant chemo-radiotherapy and the pathologic stage.
Esophagectomy still represents a valid treatment for esophageal carcinoma in well selected patients. Both pT stage and N stage appear to be the most important factors determining survival for patients with completely resected esophageal carcinoma.