Follow‐up results after resection of thoracic esophageal carcinoma

Abstract

During the past 14.5 years, we have treated 430 patients with carcinoma of the thoracic esophagus. The resection rate was 72% and the overall operative mortality rate was 16%. During the past 5 years, the operative mortality rate has been markedly reduced to 4.5%. The low operative mortality rate in recent years is the result of selection of the operative procedure according to the criteria that we have established for one-stage radical rese~ion. The overall 5year survival rate was 16.5%. Prophylactic postoperative irradiation improved long-term survival,:4n patients who underwent curative resection; their 5-year survival rate was 34.6%. Prophylactic irradiation was:especially effective in patients who did not have lymph node r~etastases. The 5year survival rate was 87.5% in these patients. The majority of long-term survivors were leading a normal life for their age.

Prognostic Impact of the Period between Surgery and Postoperative Irradiation in Esophageal Carcinoma.

“…The difference of survival rates as related to the waiting period became clear after the follow-up of more than four years. The prognostic difference of subclinical tumors seems to be uncovered several years after treatment, esophageal carcinoma; surgery; postoperative irradiation; waiting period Postoperative irradiation for esophageal carcinoma has improved the prognosis (Kasai et al 1978;Nishihira et al 1984). In general, postoperative irradiation should be started as soon as possible after surgery, because a delay of the irradiation may result in regrowth of the residual tumor cells.…”

“…Postoperative irradiation for esophageal carcinoma has improved the prognosis (Kasai et al 1978;Nishihira et al 1984). In general, postoperative irradiation should be started as soon as possible after surgery, because a delay of the irradiation may result in regrowth of the residual tumor cells.…”

Postoperative cancer therapy for patients with carcinoma of the thoracic esophagus: An attempt of aggressive chemotherapy combined with proper nutritional support for patients with distant node metastasis.

“…As Kasai reported previously, however, postoperative radiotherapy against esophageal cancer was quite effective for patients with negative nodes, but not for patients with positive nodes (Kasai et al 1978). Thereafter, 78 patients were treated with postoperative radiotherapy.…”

Combined Treatment Modalities in Esophageal Cancer: Should chemotherapy be included?

“…Two Japanese studies favor the use of postoperative RT, one using historical controls (21) and one randomized trial (22). In a French randomized trial, however, comparing surgery with surgery followed by RT including 221 patients it was shown that postoperative RT (45-55 Gy, 1.8 Gy/fraction) did not affect survival after curative esophageal resection (23).…”