Skip to main content

Advertisement

Log in

Survival after oesophagectomy for cancer of the oesophagus

  • Current Concepts in Clinical Surgery
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

Formerly an inevitably fatal disease, oesophageal cancer today has predictable chances for cure.

Methods

The recent literature and authors’ own experiences in the surgical management of oesophageal cancer was reviewed to identify factors associated with improved survival after oesophagectomy.

Results

Currently reported overall 5-year-survival rates are reaching 40% and more in patients who have had an oesophagectomy performed with curative intention. The reasons for improved survival after surgical resection are multifactorial in nature: decreased postoperative mortality and morbidity (due to improved patient selection, surgical technique and perioperative management), the use of tailored surgical strategies (adopted to the histological tumour type, tumour location, stage of disease and the individual patient’s risk profile), and multimodality treatment in patients with locally advanced disease.

Conclusion

The prognosis of patients who have had oesophagectomy for oesophageal cancer has markedly improved during the past decades. With improved long-term survival after oesophagectomy, postoperative quality of life gains importance as an additional parameter of outcome after oesophageal cancer surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Adegboye VO, Obajimi MO, Ogunseyinde AO, Brimmo IA, Adebo AO (2002) Trans-hiatal oesophagectomy as palliative treatment for carcinoma of the oesophagus. East Afr Med J 79:311–316

    CAS  PubMed  Google Scholar 

  2. Ando N, Ozawa S, Kitagawa Y, Shinozawa Y, Kitajima M (2000) Improvement in the result of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 232:225–232

    Article  CAS  PubMed  Google Scholar 

  3. Baba M, Aikou T, Natsugoe S, Kusano C, Shimada M, Kimura S, Fukumoto T (1997) Appraisal of ten-year survival following esophagectomy for carcinoma of the esophagus with emphasis on quality of life. World J Surg 21:282–285

    Article  CAS  PubMed  Google Scholar 

  4. Bartels H, Stein HJ, Siewert JR (1998) Preoperative risk analysis and postoperative mortality of esophagectomy for resectable esophageal cancer. Br J Surg 85:840–844

    Article  CAS  PubMed  Google Scholar 

  5. Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE (2002) Hospital volume and surgical mortality in the United States. N Engl J Med 346:1128–1137

    Article  PubMed  Google Scholar 

  6. Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL (2003) Surgeon volume and operative mortality in the United States. N Engl J Med 349:2117–2127

    Article  CAS  PubMed  Google Scholar 

  7. Blazeby JM, Alderson D, Farndon JR (2000) Quality of life in patients with oesophageal cancer. Recent Results Cancer Res 155:193–204

    CAS  PubMed  Google Scholar 

  8. Blazeby JM, Farndon JR, Donovan J, Alderson D (2000) A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma. Cancer 88:1781–1787

    Article  CAS  PubMed  Google Scholar 

  9. De Boer AG, Genovesi PI, Sprangers MA, Van Sandick JW, Obertop H, Van Lanschot JJ (2000) Quality of life in long-term survivors after curative transhiatal oesophagectomy for oesophageal carcinoma. Br J Surg 87:1716–1721

    Article  PubMed  Google Scholar 

  10. Devesa SS, Blot WJ, Fraumeni JF Jr (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83:2049–2053

    Article  CAS  PubMed  Google Scholar 

  11. Dimick JB, Pronovost PJ, Cowan JA, Lipsett PA (2003) Surgical volume and quality of care for esophageal resection: do high-volume hospitals have fewer complications? Ann Thorac Surg 75:337–341

    Article  PubMed  Google Scholar 

  12. Earlam R, Cunha-Melo JR (1980) Oesophageal squamous cell carcinoma: a critical review of surgery. Br J Surg 67:381–390

    CAS  PubMed  Google Scholar 

  13. Hofstetter W, Swisher SG, Correa AM, Hess K, Putnam JB Jr, Ajani JA, Dolormente M, Francisco R, Komaki RR, Lara A, Martin F, Rice DC, Sarabia AJ, Smythe WR, Vaporciyan AA, Walsh GL, Roth JA (2002) Treatment outcomes of resected esophageal cancer. Ann Surg 236:376–384

    Article  PubMed  Google Scholar 

  14. Hulscher JB, van Sandick JW, de Boer AG, Wijnhoven BP, Tijssen JG, Fockens P, Stalmeier PF, ten Kate FJ, van Dekken H, Obertop H, Tilanus HW, van Lanschot JJ (2002) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347:1662–1669

    Article  PubMed  Google Scholar 

  15. Kirby L (1999) Quality of life after oesophagectomy: the patient’s perspective. Dis Esophagus 12:168–171

    Article  CAS  PubMed  Google Scholar 

  16. Kitajima M, Kitagawa Y (2002) Surgical treatment of esophageal cancer—the advent of the era of individualization. N Engl J Med 347:1705–1709

    Article  PubMed  Google Scholar 

  17. Law S, Kwong DL, Kwok KF, Wong KH, Chu KM, Sham JS, Wong J (2003) Improvement in treatment results and long-term survival of patients with esophageal cancer: impact of chemoradiation and change in treatment strategy. Ann Surg 238:339–347

    Article  PubMed  Google Scholar 

  18. Lordick F, Stein HJ, Peschel C, Siewert JR (2004) Neoadjuvant therapy in oesophago-gastric cancer. Br J Surg 91:540–551

    Article  CAS  PubMed  Google Scholar 

  19. McCulloch P, Ward J, Tekkis PT (2003) Mortality and morbidity in gastro-oesophageal cancer surgery: initial results of ASCOT multicentre prospective cohort study. BMJ 327:1192–1197

    Article  PubMed  Google Scholar 

  20. McLarty AJ, Deschamps C, Trastek VF, Allen MS, Pairolero PC, Harmsen WS (1997) Esophageal resection for cancer of the esophagus: long-term function and quality of life. Ann Thorac Surg 63:1568–1572

    Article  CAS  PubMed  Google Scholar 

  21. Medical Research Council Oesophageal Cancer Working Group (2002) Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 359:1727–1733

    Article  PubMed  Google Scholar 

  22. Patti MG, Corvera CU, Glasgow RE, Way LW (1998) A hospital’s annual rate of esophagectomy influences the operative mortality rate. J Gastrointest Surg 2:186–192

    Article  CAS  PubMed  Google Scholar 

  23. von Rahden BHA, Stein HJ, Siewert JR (2003) Barrett’s esophagus and Barrett’s carcinoma. Curr Oncol Rep 5:203–209

    PubMed  Google Scholar 

  24. Siewert JR, Stein HJ (1999) Lymphadenectomy for esophageal cancer. Langenbecks Arch Surg 384:141–148

    Article  CAS  PubMed  Google Scholar 

  25. Siewert JR, Feith M, Werner M, Stein HJ (2000) Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg 232:353–361

    PubMed  Google Scholar 

  26. Siewert JR, Stein HJ, Feith M, Bruecher BL, Bartels H, Fink U (2001) Histologic tumor type is an independent prognostic parameter in esophageal cancer: lessons from more than 1,000 consecutive resections at a single center in the Western world. Ann Surg 234:360–367

    Article  CAS  PubMed  Google Scholar 

  27. Siewert JR, Stein HJ, Feith M (2003) Surgical approach to invasive adenocarcinoma of the distal esophagus (Barrett’s Cancer). World J Surg 27:1058–1061

    Article  PubMed  Google Scholar 

  28. Stein HJ, Siewert JR (2004) Improved prognosis of resected esophageal cancer. World J Surg (in press)

  29. Stein HJ, Feith M, Mueller J, Werner M, Siewert JR (2000) Limited resection for early Barrett’s cancer. Ann Surg 232:733–742

    Article  CAS  PubMed  Google Scholar 

  30. Stein HJ, Sendler A, Fink U, Siewert JR (2000) Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am 80:659–682

    CAS  PubMed  Google Scholar 

  31. Stein HJ, Brucher BL, Sendler A, Siewert JR (2001) Esophageal cancer: patient evaluation and pre-treatment staging. Surg Oncol 10:103–111

    Article  CAS  PubMed  Google Scholar 

  32. Stein HJ, Bartels H, Siewert JR (2001) [Esophageal carcinoma: 2-stage operation for preventing mediastinitis in high risk patients] Chirurg 72:881–886

    Google Scholar 

  33. Stein HJ, Feith M, Siewert JR (2003) Approach to early Barrett’s cancer. World J Surg 27:1040–1046

    Article  PubMed  Google Scholar 

  34. Stein HJ, Theisen J, Siewert JR (2004) Surgical resection for esophageal cancer: role of extended lymphadenectomy. In: Fielding JWL, Hallissey MT (eds) Upper gastrointestinal surgery. Springer, New York Berlin Heidelberg (in press)

  35. Tabira Y, Yasunaga M, Nagamoto N, Matsushita H, Fukunaga Y, Ihara T, Kawasuji M (2002) Quality of life after esophagectomy for cancer: an assessment using the questionnaire with the face scale. Surg Today 32:213–219

    Article  PubMed  Google Scholar 

  36. Tekkis PP, McCulloch P, Poloniecki JD, Prytherch DR, Kessaris N, Steger AC (2004) Risk-adjusted prediction of operative mortality in oesophagogastric surgery with O-POSSUM. Br J Surg 91:288–295

    Article  CAS  PubMed  Google Scholar 

  37. Walsh TN, Noonan N, Hollywood D, Kelly A, Keeling N, Hennessy TP (1996) A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med 335:462–467

    Article  CAS  PubMed  Google Scholar 

  38. Wu PC, Posner MC (2003) The role of surgery in the management of oesophageal cancer. Lancet Oncol 4:481–488

    Article  PubMed  Google Scholar 

  39. Zacherl J, Sendler A, Stein HJ, Ott K, Feith M, Jakesz R, Siewert J R, Fink U (2003) Current status of neoadjuvant therapy for adenocarcinoma of the distal esophagus. World J Surg 27:1067–1074

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hubert J. Stein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, H.J., von Rahden, B.H.A. & Siewert, J.R. Survival after oesophagectomy for cancer of the oesophagus. Langenbecks Arch Surg 390, 280–285 (2005). https://doi.org/10.1007/s00423-004-0504-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-004-0504-9

Keywords

Navigation