Results of resection of carcinoma of the esophagus and cardia in 196 patients

Abstract

During the period 1962–1976, 196 patients were operated on for carcinoma of the esophagus (51) and cardia (145). In all patients resection with primary esophagogastrostomy or esophagojejunostomy was performed. Metastases involving the regional lymph nodes were found in 54.2% of patients. The early postoperative mortality rate was 21.9%. The most common cause of death was leakage at the esophagogastric anastomosis (46.5% of deaths). Mean survival period was 16.2 months, overall 5‐year survival rate was 18.7%, and 5‐year survival rate excluding early post‐operative mortality was 21.7%. Mean survival period in patients who had resection of the esophagus with negative lymph nodes was 13.5 months and in those with positive nodes was 8.1 months. Mean survival time in patients after resection of the cardia was 19.7 months if nodes were negative and 8.2 months if nodes were positive. The most frequent cause of late death was advanced cancer and distant metastases. Postoperatively, most patients were able to adopt their previous mode of life. All living patients but 1 are ambulatory, 2/3 perform work that is the same as or easier than that prior to the onset of the illness, they have no difficulty in consuming food, and are physically fit. The most common side effect was heartburn due to reflux esophagitis.

Carcinoma of the gastric cardia: Surgical management and long‐term survival

“…Adenocarcinomas of the gastric cardia and squamous cell carcinomas of the esophagus were mixed in several series [4][5][6][7][8][9][10][11][12][13][14][15] and should be reported separately because their natural behavior and prognosis are different. Carcinomas arising from the upper part in the stomach included in a previous report [16] were excluded in the present series, and, in every case, carcinoma was estimated to have arisen from the gastroesophageal junction.…”

Gastric Cancer Invading the Esophagus. Improved Management.

“…In the present study, the 5 year-survival rate in stage III was 12% for Group 1 and 46% for Group 2 which usually underwent more radical operations including combined resections of the diaphragm and lymphadenectomy beyond the paraaortic lymph nodes (Hashimoto et al 1990). Orel et al (1981) reported the disrupted anastomosis and cardiorespiratory fairure accounted for most of the postoperative morbidity and mortality.…”

Carcinoma of the Gastric Cardia: Surgical Practices and Short‐term Operative Results in a Defined Swedish Population

“…Anastomotic leakage has been reported to be the main postoperative complication and the main cause of death after surgery for tumors of the gastric cardia [13,18,19]. In this populationbased study there tended to be a higher frequency of anastomotic leakage than in some previous case series [19,20], but only 5 of 14 postoperative deaths after resective surgery could be partly or totally attributed to this complication.…”