SURGICAL OUTCOME OF TWENTY-THREE ESOPHAGEAL CANCER CASES

Purpose: We reported the surgical outcome of 23 cases with esophageal cancer to whom we performed resection in a period of 4.5 years in our department. Material and Method: Twenty-three patients with esophageal cancer were operated at Yüzüncü Yıl University, School of Medicine, Department of Thoracic Surgery between June 1996 and December 2000 (14 female and 9 male patients). Median age was 50.8 (range, 31 to 73) years. The localization of the tumor was upper thoracic esophagus in 1 patient, middle thoracic esophagus in 11 patients, and lower thoracic esophagus in 11. A complete resection was performed through laparotomy and right thoracotomy in 12 patients, transhiatal in 2 patients and right thoracotomy plus laparotomy and servical incision in 9 patients. Results: Eight patients were stage II, 12 patients were stage III and 3 patients were stage IV at postsurgical staging. The postoperative anastomotic leakage occurred in 2 patients and both died as a result of this complication. The other 3 patients died of cardiopulmonary complications giving a total mortality rate of 21.7 % in all the cases. Five patients had 1-3 courses of chemotherapy. Two patients were lost during follow up and 3 patients are still alive (30, 20 and 9 months of follow up - considering the date of May 31, 2001). Survival of other 13 cases ranged between 6 months and 26 months (mean 17.2 months). Conclusion: In esophagus carcinoma, the most effective treatment is surgery both for curative or palliative intention. But survival rate of high stage patients is poor. Chemotherapy and/or radiotherapy must be added postoperatively.

Keywords: esophageal cancer, surgical treatment, prognosis