Background
In Japan, most esophageal cancers are squamous cell carcinomas, and the results of
esophagectomy have improved remarkably in recent years. The object of this study was
to evaluate advances in operative therapy for esophageal cancer in Japan.
Method
We evaluated mortality, morbidity, and prognosis in 1000 consecutive patients who
underwent esophagectomy for esophageal cancer at a single institution in Japan. The
patients were divided into 3 groups according to the period when esophagectomy was
performed: Group I (n = 197), 1964–1980; group II (n = 432), 1981–1993; and group
III (n = 371), 1993–2006.
Results
The incidence of squamous cell carcinoma was 94%. The morbidity rates were 62%, 38%,
and 33 %, in groups I, II, and III, respectively (P < 0.01, groups I vs II and III), and the in-hospital mortality rates were 14.2%,
5.1%, and 2.4%, respectively (P < 0.01, between each group). The 5-year overall survival rate was 30% (14%, 27%,
and 46% in groups I, II, and III, respectively; P < 0.0001). Multivariate analysis revealed age, gender, depth of invasion, node metastasis,
distant metastasis, curability, extent of lymphadenectomy, resectability, and the
period when the operation was performed as independent prognostic factors.
Conclusion
Generally, esophagectomy has been performed safely without critical complications;
however, the prognosis has improved remarkably with advances in surgical techniques
and treatment modalities.
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Article info
Publication history
Published online: February 27, 2008
Accepted:
December 7,
2007
Footnotes
Supported in part by a Grant-in-Aid from the Ministry of Education, Culture, Sport, Science and Technology of Japan.
Presented at the 2007 Annual Meeting of the American Society of Clinical Oncology, Chicago, Illinois, June 1-5, 2007.
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
