Esophagus

, Volume 13, Issue 2, pp 110–137 | Cite as

Comprehensive Registry of Esophageal Cancer in Japan, 2009

  • Yuji Tachimori
  • Soji Ozawa
  • Hodaka Numasaki
  • Mitsuhiro Fujishiro
  • Hisahiro Matsubara
  • Tsuneo Oyama
  • Masayuki Shinoda
  • Yasushi Toh
  • Harushi Udagawa
  • Takashi Uno
  • The Registration Committee for Esophageal Cancer of the Japan Esophageal Society
Open Access
Special Article

Preface 2009

We deeply appreciate the great contributions of many physicians in the registry of esophageal cancer cases. The Comprehensive Registry of Esophageal Cancer in Japan, 2009 was published here, despite some delay. The registry complies with the Act for the Protection of Personal Information. The encryption with a HASH function is used for ‘‘anonymity in an unlinkable fashion’’.

We briefly summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2009. Japanese Classification of Esophageal Cancer 10th and UICC TNM Classification 6th were used for cancer staging according to the subjected year. A total of 6260 cases were registered from 276 institutions in Japan. Tumor locations were cervical: 4.4 %, upper thoracic: 11.9 %, middle thoracic: 48.0 %, lower thoracic: 27.7 % and EG junction: 6.6 %. Superficial carcinomas (Tis, T1a, T1b) were 36.7 %. As for the histologic type of biopsy specimens, squamous cell carcinoma and adenocarcinoma accounted for 90.5 and 3.8 %, respectively. Regarding clinical results, the 5-year survival rates of patients treated using endoscopic mucosal resection, concurrent chemoradiotherapy, radiotherapy alone, chemotherapy alone, or esophagectomy were 86.2, 27.9, 20.2, 5.8, and 55.9 %, respectively. Esophagectomy was performed in 3844 cases. Concerning the approach used for esophagectomy, 24.9 % of the cases were treated thoracoscopically. The operative mortality (within 30 days after surgery) was 1.01 % and the hospital mortality was 4.76 %.

We hope that this Comprehensive Registry of Esophageal Cancer in Japan, 2009 will help to improve all aspects of the diagnosis and treatment of esophageal cancer in Japan.

Contents

  1. I.
    Clinical factors of esophageal cancer patients treated in 2009
    1. 1.

      Institution-registered cases in 2009

       
    2. 2.
      Patient Background
      • Table1Age and gender

      • Table2Primary treatment

      • Table3Tumor location

      • Table4Histologic types of biopsy specimens

      • Table5Depth of tumor invasion, cT (UICC TNM 6th)

      • Table6Lymph node metastasis, cN (UICC TNM 6th)

      • Table7Distant metastasis, cM (UICC TNM 6th)

      • Table8Clinical stage (UICC TNM 6th)

       
     
  2. II.
    Results of endoscopically treated patients in 2009
    • Table9Details of endoscopic treatment

    • Table10Complications of EMR/ESD

    • Table11Pathological depth of tumor invasion of EMR/ESD specimens

    • Figure1Survival of patients treated with EMR/ESD
      Fig. 1

      Survival of patients treated with EMR/ESD

    • Figure2Survival of patients treated with EMR/ESD according to the pathological depth of tumor invasion (pT)
      Fig. 2

      Survival of patients treated with EMR/ESD according to the pathological depth of tumor invasion (pT)

    • Figure3Survival of patients treated with EMR/ESD according to the lymphatic and venous invasion
      Fig. 3

      Survival of patients treated with EMR/ESD according to the lymphatic and venous invasion

     
  3. III.
    Results in patients treated with chemotherapy and/or radiotherapy in 2009
    • Table12Dose of radiation (non-surgically treated cases)

    • Table13Dose of radiation (surgically treated cases)

    • Figure4Survival of patients treated with chemotherapy and/or radiotherapy (cStage I-IIA)
      Fig. 4

      Survival of patients treated with chemotherapy and/or radiotherapy (cStage I-IIA)

    • Figure5Survival of patients treated with chemotherapy and/or radiotherapy (cStage IIB-IVB)
      Fig. 5

      Survival of patients treated with chemotherapy and/or radiotherapy (cStage IIB-IVB)

     
  4. IV.
    Results in patients underwent esophagectomy in 2009
    • Table14Treatment modalities of esophagectomy

    • Table15Tumor location

    • Table16Approaches to tumor resection

    • Table17Video-assisted surgery

    • Table18Fields of lymph node dissection according to the location of the tumor

    • Table19Reconstruction route

    • Table20Organs used for reconstruction

    • Table21Histological classification

    • Table22Depth of tumor invasion, pT (JES 10th)

    • Table23Pathological grading of lymph node metastasis, pN (JES 10th)

    • Table24Numbers of the metastatic nodes

    • Table25Pathological findings of distant organ metastasis, pM (JES 10th)

    • Table26Residual tumor, R

    • Table27Causes of death

    • Figure6Survival of patients who underwent esophagectomy
      Fig. 6

      Survival of patients who underwent esophagectomy

    • Figure7Survival of patients who underwent esophagectomy according to clinical stage (JES TNM 10th)
      Fig. 7

      Survival of patients who underwent esophagectomy according to clinical stage (JES TNM 10th)

    • Figure8Survival of patients who underwent esophagectomy according to clinical stage (UICC TNM 6th)
      Fig. 8

      Survival of patients who underwent esophagectomy according to clinical stage (UICC TNM 6th)

    • Figure9Survival of patients who underwent esophagectomy according to the depth of tumor invasion (JES 10th: pT)
      Fig. 9

      Survival of patients who underwent esophagectomy according to the depth of tumor invasion (JES 10th: pT)

    • Figure10Survival of patients who underwent esophagectomy according to the depth of tumor invasion (UICC TNM 6th: pT)
      Fig. 10

      Survival of patients who underwent esophagectomy according to the depth of tumor invasion (UICC TNM 6th: pT)

    • Figure11Survival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th: pN)
      Fig. 11

      Survival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th: pN)

    • Figure12Survival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 6th: pN)
      Fig. 12

      Survival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 6th: pN)

    • Figure13Survival of patients who underwent esophagectomy according to number of metastatic nodes
      Fig. 13

      Survival of patients who underwent esophagectomy according to number of metastatic nodes

    • Figure14Survival of patients who underwent esophagectomy according to pathological stage (JES 10th)
      Fig. 14

      Survival of patients who underwent esophagectomy according to pathological stage (JES 10th)

    • Figure15Survival of patients who underwent esophagectomy according to pathological stage (UICC TNM 6th)
      Fig. 15

      Survival of patients who underwent esophagectomy according to pathological stage (UICC TNM 6th)

    • Figure16Survival of patients who underwent esophagectomy according to residual tumor (R)
      Fig. 16

      Survival of patients who underwent esophagectomy according to residual tumor (R)

     

I. Clinical factors of esophageal cancer patients treated in 2009

Institution-registered cases in 2009

Institutions

Aichi Cancer Center

Aizawa Hospital

Akita University Hospital

Aomori Municipal Hospital

Aomori Prefectural Central Hospital

Arao Municipal Hospital

Asahikawa Medical College Hospital

Chiba Cancer Center

Chiba Medical Center

Chiba University Hospital

Chibaken Saiseikai Narashino Hospital

Dokkyo Medical University Hospital

Ehime University Hospital

Foundation for Detection of Early Gastric Carcinoma

Fuchu Hospital

Fujioka General Hospital

Fujisawa Shounandai Hospital

Fujita Health University

Fukui Prefectural Hospital

Fukui University Hospital

Fukuoka Dental College and Dental Hospital

Fukuoka Saiseikai General Hospital?

Fukuoka University Hospital

Fukuoka Wajiro Hospital

Fukushima Medical University Hospital

Fukuyama City Hopital

Gifu Prefectural General Medical Center

Gifu University Hospital

Gunma Central General Hospital

Gunma Prefectural Cancer Center

Gunma University Hospital

Gunmaken Saiseikai Maebashi Hospital

Hachinohe City Hospital

Hakodate Goryokaku Hospital

Hakodate National Hospital

Hamamatsu University School of Medicine, University Hospital

Handa City Hospital

Hannan Chuo Hospital

Heartlife Hospital

Higashiosaka City General Hospital

Hino Memorial Hospital

Hiratsuka City Hospital

Hiratsuka Kyosai Hospital

Hirosaki University Hospital

Hiroshima City Asa Hospital

Hiroshima University Research Institute for Radiation Biology Medicine

Hitachi General Hospital

Hofu Institute of Gastroenterology

Hokkaido Kin-Ikyo Chuo Hospital

Hokkaido University Hospital

Hyogo Cancer Center

Hyogo College of Medicine

Hyogo Prefectural Nishinomiya Hospital

Ibaraki Prefectural Central Hospital

Iizuka Hospital

Imazu Surgical Clinic

Inazawa City Hospital

Internatinal University of Health and Welfare Hospital

Isehara Kyodo Hospital

Ishikawa Prefectural Central Hospital

Iwakuni Medical Center

Iwate Medical University Hospital

Iwate Prefectural Chubu Hospital

Iwate Prefectural Isawa Hospital

Japanese Red Cross Fukui Hospital

Japanese Red Cross Ishinomaki Hospital

Japanese Red Cross Kyoto Daini Hospital?

Japanese Red Cross Maebashi Hospital

Japanese Red Cross Nagaoka Hospital

Japanese Red Cross Narita Hospital

Japanese Red Cross Nasu Hospital

Jichi Medical University Hospital

Juntendo University Hospital

Juntendo University Shizuoka Hospital

Junwakai Memorial Hospital

Kagawa Rosai Hospital

Kagawa University Hospital

Kagoshima Kenritsu Satsunan Hospital

Kagoshima University Hospital

Kameda General Hospital

Kanagawa Cancer Center

Kanazawa Medical University Hospital

Kanazawa University Hospital

Kansai Medical University Hirakata Hospital

Kansai Rosai Hospital

Kashiwa Kousei General Hospital

Kawakita General Hospital

Kawasaki Medical School Hospital

Kawasaki Medical School Kawasaki Hospital

Kawasaki Municipal Hospital

Kawasaki Municipal Ida Hospital

Keio University Hospital

Keiyukai Sapporo Hospital

Kikuna Memorial Hospital

Kinki Central Hospital

Kinki University Hospital

Kiryu Kosei General Hospital

Kishiwada City Hospital

Kitaakita Municipal Hospital

Kitakyushu Municipal Medical Center

Kitano Hospital

Kitasato University Hospital

Kobe City Medical Center General Hospital

Kobe University Hospital

Kochi University Hospital

Kokura Memorial Hospital

Kumamoto City Hospital

Kumamoto University Hospital

Kurashiki Central Hospital

Kurume General Hospital

Kurume University Hospital

Kuwana West Medical Center

Kyoto University Hospital

Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers

Kyushu University Beppu Hospital

Kyushu University Hospital

Kyushu Medical Center

Machida Municipal Hospital

Matsuda Hospital

Matsushita Memorial Hospital

Matsuyama Red Cross Hospital

Mie University Hospital

Mino City Hospital

Mito Red Cross Hospital

Mitsui Memorial Hospital

Miyazaki Konan Hospital

Murakami General Hospital

Musashimurayama Hospital

Musashino Red Cross Hospital

Nagahama City Hospital

Nagano Red Cross Hospital

Nagaoka Chuo General Hospital

Nagasaki University Hospital

Nagayoshi General Hospital

Nagoya City University Hospital

Nagoya City West Medical Center

Nagoya Daiichi Red Cross Hospital

Nagoya University Hospital

Nara Hospital Kinki University Faculty of Medicine

Nara Medical University Hospital

National Cancer Center Hospital

National Cancer Center Hospital East

National Center for Global Health and Medicine

National Defense Medical College Hospital

National Hospital Organization Beppu Medical Center

National Hospital Organization Chiba-East-Hospital

National Hospital Organization Fukuoka-higashi Medical Center

National Hospital Organization Kure Medical Center

National Hospital Organization Kyoto Medical Center

National Hospital Organization Kyushu Cancer Center

National Hospital Organization Matsumoto National Hospital

National Hospital Organization Nagasaki Medical Center.

National Hospital Organization Nagoya Medical Center

National Hospital Organization Osaka National Hospital

National Hospital Organization Tokyo Medical Center

Niigata Cancer Center Hospital

Niigata City General Hospital

Niigata Prefectural Shibata Hospital

Niigata University Medical and Dental Hospital

Nikko Memorial Hospital

Nippon Medical School Chiba Hokusoh Hospital

Nippon Medical School Hospital

Nippon Medical School Musashi Kosugi Hospital

Nippon Medical School Tama Nagayama Hospital

Nishi-Kobe Medical Center

Nishinomiya Municipal Central Hospital

Numazu City Hospital

Obihiro Kousei General Hospital

Ohta General Hospital Foundation Ohta Nishinouchi Hospital

Oita Red Cross Hospital

Oita University Hospital

Okayama Saiseikai General Hospital

Okayama University Hospital

Onomichi Municipal Hospital

Osaka City General Hospital

Osaka City University Hospital

Osaka Hospital of Japan Seafarers relief Association

Osaka Medical Center for Cancer and Cardiovascular Diseases

Osaka Medical College Hospital

Osaka Police Hospital

Osaka Prefectural Hospital Organization Osaka General Medical Center

Osaka Red Cross Hospital

Osaka University Hospital

Otsu Municipal Hospital

Otsu Red Cross Hospital

Rakusei Hospital

Ryukyu University Hospital

Saga University Hospital

Saga-ken Medical Center Koseikan

Saiseikai Fukushima General Hospital

Saiseikai Hiroshima Hospital

Saiseikai Kyoto Hospital

Saiseikai Utsunomiya Hospital

Saitama City Hospital

Saitama Medical Center Jichi Medical University

Saitama Medical University Hospital

Saitama Medical University Saitama International Medical Center

Saitama Medical University Saitama Medical Center

Saitama Medical Center

Sakai City Medical Center

Saku Central Hospital

Sanin Rosai Hospital

Sano Kousei General Hospital

Sendai City Hospital

Shiga Medical Center for Adults

Shiga University of Medical Science Hospital

Shikoku Cancer Center

Shimada Hospital

Shimane University Hospital

Shimizu Welfare Hospital

Shinshu University Hospital

Shizuoka Cancer Center

Shizuoka City Shizuoka Hospital

Shizuoka General Hospital

Showa University Hospital

Showa University Northern Yokohama Hospital

Showa University Koto-Toyosu Hospital

Social Insurance Omuta Tenryo Hospital

Social Insurance Tagawa Hospital

Yokohama Chuo Hospital

Sonoda Daiichi Hospital

St. Marianna University School of Medical Hospital

St. Luke’s International Hospital

Sugita Genpaku Memorial Obama Municipal Hospital

Suita Municipal Hospital

Takasago Municipal Hospital

Takatsuki Red Cross Hospital

Teikyo University Hospital

Tenri Hospital

The Cancer Institute Hospital of JFCR

The Jikei University Hospital

The Research Center Hospital for Charged Particle Therapy of NIRS

Toho University Omori Medical Center

Toho University Sakura Medical Center

Tohoku Kosai Hospital

Tohoku University Hospital

Tokai University Hachioji Hospital

Tokai University Hospital

Tokai University Tokyo Hospital

Tokushima Municipal Hospital

Tokushima Red Cross Hospital

Tokushima University Hospital

Tokyo Dental College Ichikawa General Hospital

Tokyo Medical and Dental University Hospital

Tokyo Medical University Hospital

Tokyo Medical University Ibaraki Medical Center

Tokyo Metropolitan Cancer and Infectious Center Komagome Hospital

Tokyo Metropolitan Health and Medical Corporation Toshima Hospital

Tokyo University Hospital

Tokyo Women’s Medical University Hospital

Tokyo Women’s Medical University Medical Center East

Tonan Hospital

Tone Chuou Hospital

Tottori Prefectural Central Hospital

Tottori University Hospital

Toyama Prefectural Central Hospital

Toyama University Hospital

Tsuchiura Kyodo Hospital

Tsukuba University Hospital

Tsuruoka Municipal Shonai Hospital

“University Hospital, Kyoto Prefectural University of Medicine”

University of Miyazaki Hospital

Wakayama Medical University Hospital

Yamagata Prefectural and Sakata Municipal Hospital Organization

Yamagata Prefectural Central Hospital

Yamagata Prefectural Shinjo Hospital

Yamagata University Hospital

Yamaguchi University Hospital

Yamaguchi-ken Saiseikai Shimonoseki General Hospital

Yamanashi Prefectural Central Hospital

Yamanashi University Hospital

Yao Municipal Hospital

Yokohama City Municipal Hospital

Yokohama City University Hospital

Yokohama City University Medical Center

Yuri General Hospital

(Total 276 institutions)

Patient Background

Table 1

Age and gender

Age

Male

Female

Unknown

Cases (%)

~29

6

1

0

7 (0.1 %)

30–39

12

6

0

18 (0.3 %)

40–49

121

34

0

155 (2.5 %)

50–59

946

173

1

1120 (17.9 %)

60–69

2332

354

0

2686 (42.9 %)

70–79

1575

270

1

1846 (29.5 %)

80–89

303

75

0

378 (6.0 %)

90~

16

3

0

19 (0.3 %)

Unknown

27

4

0

31 (0.5 %)

Total

5338

920

2

6260 (100 %)

Table 2

Primary treatment

Treatments

Cases (%)

Surgery

3943 (63.0 %)

Esophagectomy

3844 (61.8 %)

Palliative

99 (1.2 %)

Chemotherapy/radiotherapy

1383 (22.1 %)

Endoscopic treatment

932 (14.9 %)

Others

2 (0.0 %)

Total

6260 (100 %)

Table 3

Tumor location

Location of tumor

Endoscopic treatment (%)

Chemotherapy and/or radiotherapy (%)

Palliative surgery (%)

Esophagectomy (%)

Other (%)

Total (%)

Cervical

18 (1.9 %)

112 (8.1 %)

9 (9.1 %)

137 (3.6 %)

0

276 (4.4 %)

Upper thoracic

105 (11.3 %)

184 (13.3 %)

19 (19.2 %)

437 (11.4 %)

0

745 (11.9 %)

Middle thoracic

511 (54.8 %)

665 (48.1 %)

50 (50.5 %)

1778 (46.3 %)

1 (50.0 %)

3005 (48.0 %)

Lower thoracic

243 (26.1 %)

325 (23.5 %)

18 (18.2 %)

1147 (29.8 %)

0

1733 (27.7 %)

E > G

40 (4.3 %)

38 (2.7 %)

2 (2.0 %)

245 (6.4 %)

0

325 (5.2 %)

E = G

5 (0.5 %)

6 (0.4 %)

0

41 (1.1 %)

0

52 (0.8 %)

G > E

0

2 (0.1 %)

0

34 (0.9 %)

0

36 (0.6 %)

Unknown

10 (1.1 %)

51 (3.7 %)

1 (1.0 %)

25 (0.7 %)

1 (50.0 %)

88 (1.4 %)

Total

932 (100 %)

1383 (100 %)

99 (100 %)

3844 (100 %)

2 (100 %)

6260 (100 %)

E esophageal, G gastric

Table 4

Histologic types of biopsy specimens

Histologic types

Cases (%)

Squamous cell carcinoma

5665 (90.5 %)

Squamous cell carcinoma

3827 (61.1 %)

Well differentiated

354 (5.7 %)

Moderately differentiated

1140 (18.2 %)

Poorly differentiated

344 (5.5 %)

Adenocarcinoma

296 (4.7 %)

Adenosquamous carcinoma

13 (0.2 %)

Mucoepidermoid carcinoma

1 (0.0 %)

Basaloid carcinoma

22 (0.4 %)

Neuroendocrine cell carcinoma

14 (0.2 %)

Undifferentiated carcinoma

10 (0.2 %)

Malignant melanoma

7 (0.1 %)

Carcinosarcoma

17 (0.3 %)

Other tumors

28 (0.4 %)

Unknown

187 (3.0 %)

Total

6260 (100 %)

Table 5

Depth of tumor invasion, cT (UICC TNM 6th)

cT

Cases (%)

cTX

29 (0.5 %)

cT0

11 (0.2 %)

cTis

157 (2.5 %)

cT1

359 (5.7 %)

cT1a

650 (10.4 %)

cT1b

1134 (18.1 %)

cT2

868 (13.9 %)

cT3

2252 (36.0 %)

cT4

701 (11.2 %)

Unknown

99 (1.6 %)

Total

6260 (100 %)

Table 6

Lymph node metastasis, cN (UICC TNM 6th)

cN

Cases (%)

cNX

72 (1.2 %)

cN0

2920 (46.6 %)

cN1

3157 (50.4 %)

Unknown

111 (1.8 %)

Total

6260 (100 %)

Table 7

Distant metastasis, cM (UICC TNM 6th)

cM

Cases (%)

cMX

57 (0.9 %)

cM0

5295 (84.6 %)

cM1

223 (3.6 %)

cM1a

141 (2.3 %)

cM1b

466 (7.4 %)

Total

6260 (100 %)

Table 8

Clinical Stage (UICC TNM 6th)

Location of tumor

Endoscopic treatment (%)

Chemotherapy and/or radiotherapy (%)

Palliative surgery (%)

Esophagectomy (%)

Other (%)

Total (%)

0

131 (14.1 %)

6 (0.4 %)

1 (1.0 %)

13 (0.3 %)

0

151 (2.4 %)

I

658 (70.6 %)

152 (11.0 %)

2 (2.0 %)

964 (25.1 %)

0

1776 (28.4 %)

IIA

6 (0.6 %)

125 (9.0 %)

7 (7.1 %)

717 (18.7 %)

0

855 (13.7 %)

IIB

7 (0.8 %)

98 (7.1 %)

2 (2.0 %)

555 (14.4 %)

0

662 (10.6 %)

III

29 (3.1 %)

452 (32.7 %)

62 (62.6 %)

1243 (32.3 %)

1 (50.0 %)

1787 (28.5 %)

IV

10 (1.1 %)

139 (10.1 %)

7 (7.1 %)

44 (1.1 %)

0

200 (3.2 %)

IVA

5 (0.5 %)

53 (3.8 %)

1 (1.0 %)

81 (2.1 %)

0

140 (2.2 %)

IVB

18 (1.9 %)

265 (19.2 %)

12 (12.1 %)

156 (4.1 %)

0

451 (7.2 %)

Unknown

68 (7.3 %)

93 (6.7 %)

5 (5.1 %)

71 (1.8 %)

1 (50.0 %)

238 (3.8 %)

Total

932 (100 %)

1383 (100 %)

99 (100 %)

3844 (100 %)

2 (100 %)

6260 (100 %)

II. Results of endoscopically treated patients in 2009

Table 9

Details of endoscopic treatment

Treatment details

Cases (%)

EMR

201 (21.6 %)

EMR + ESD

11 (1.2 %)

EMR + YAG laser

7 (0.8 %)

ESD

607 (65.1 %)

ESD + other treatment

7 (0.8 %)

PDT

2 (0.2 %)

PDT + YAG laser

2 (0.2 %)

YAG laser

10 (1.1 %)

Esophageal stenting

70 (7.5 %)

Esophageal stenting + tracheal stenting

2 (0.2 %)

Tracheal stenting

4 (0.4 %)

Others

5 (0.5 %)

Unknown

4 (0.4 %)

Total

753 (100 %)

EMR endoscopic mucosal resection, ESD endoscopic submucosal dissection, YAG: yttrium aluminum garnet, PDT photodynamic therapy

Table 10

Complications of EMR/ESD

Complications of EMR/ESD

Cases (%)

None

766 (91.8 %)

Perforation

16 (1.9 %)

Bleeding

2 (0.2 %)

Mediastinitis

0

Stenosis

42 (5.0 %)

Others

7 (0.8 %)

Unknown

1 (0.1 %)

Total

834 (100 %)

Table 11

Pathological depth of tumor invasion of EMR/ESD specimens

Pathological depth of tumor invasion

Cases (%)

pTX

1 (0.1 %)

pT0

5 (0.6 %)

pTis

166 (19.9 %)

pT1a

507 (60.9 %)

pT1b

86 (10.3 %)

pT2

0

Unknown

68 (8.2 %)

Total

833 (100 %)

III. Results in patients treated with chemotherapy and/or radiotherapy in 2009

Table 12

Dose of radiation (non-surgically treated cases)

Dose of radiation (Gy)

Definitive

Palliative (%)

Recurrence (%)

Others (%)

Unknown (%)

Total (%)

Radiation alone (%)

With chemotherapy (%)

–29

5 (4.1 %)

18 (2.3 %)

23 (11.0 %)

2 (6.1 %)

0

1 (5.6 %)

49 (4.1 %)

30–39

1 (0.8 %)

15 (1.9 %)

25 (11.9 %)

3 (9.1 %)

1 (7.1 %)

0

45 (3.8 %)

40–49

11 (8.9 %)

40 (5.1 %)

31 (14.8 %)

9 (27.3 %)

8 (57.1 %)

1 (5.6 %)

100 (8.4 %)

50–59

24 (19.5 %)

199 (25.3 %)

47 (22.4 %)

8 (24.2 %)

2 (14.3 %)

1 (5.6 %)

281 (23.7 %)

60–69

74 (60.2 %)

493 (62.6 %)

81 (38.6 %)

9 (27.3 %)

2 (14.3 %)

15 (83.3 %)

674 (56.8 %)

70-

6 (7.2 %)

8 (2.1 %)

2 (0.0 %)

0

0

0

16 (2.2 %)

Unknown

2 (1.6 %)

15 (1.9 %)

1 (0.5 %)

2 (6.1 %)

1 (7.1 %)

0

21 (1.8 %)

Total

123 (100 %)

788 (100 %)

210 (100 %)

33 (100 %)

14 (100 %)

18 (100 %)

1186 (100 %)

Median (min–max)

60.0 (6.0–120.0)

60.0 (2.0–124.0)

54.0 (2.0–95.4)

50.0 (20.0–66.0)

40.0 (36.0–60.0)

60.0 (2.0–61.2)

60.0 (2.0–124.0)

Table 13

Dose of radiation (surgically treated cases)

Dose of radiation (Gy)

Preoperative radiation (%)

Postoperative radiation (%)

–29

3 (1.4 %)

1 (1.4 %)

30–39

54 (24.4 %)

2 (2.7 %)

40–49

132 (59.7 %)

21 (28.4 %)

50–59

9 (4.1 %)

18 (24.3 %)

60–69

15 (6.8 %)

27 (36.5 %)

70-

0

0 (1.1 %)

Unknown

8 (3.6 %)

5 (6.8 %)

Total

221 (100 %)

74 (100 %)

Median (min–max)

40.0 (15.0–66.0)

50.4 (4.0–64.0)

IV. Results in patients who underwent esophagectomy in 2009

Table 14

Treatment modalities of esophagectomy

Treatments

Cases (%)

Esophagectomy

1630 (42.4 %)

Esophagectomy + radiotherapy

65 (1.7 %)

Esophagectomy + chemoradiotherapy

655 (17.0 %)

Esophagectomy + chemoradiotherapy + endoscopic treatment

16 (0.4 %)

Esophagectomy + chemoradiotherapy + other treatment

2 (0.1 %)

Esophagectomy + radiotherapy + endoscopic treatment

3 (0.1 %)

Esophagectomy + radiotherapy + other treatment

1 (0.0 %)

Esophagectomy + chemotherapy

1385 (36.0 %)

Esophagectomy + chemotherapy + endoscopic treatment

8 (0.2 %)

Esophagectomy + chemotherapy + other treatment

2 (0.1 %)

Esophagectomy + endoscopic treatment

77 (2.0 %)

Total

3844 (100 %)

Table 15

Tumor location

Locations

Cases (%)

Cervical

137 (3.6 %)

Upper thoracic

437 (11.4 %)

Middle thoracic

1778 (46.3 %)

Lower thoracic

1147 (29.8 %)

E > G

245 (6.4 %)

E = G

41 (1.1 %)

G > E

34 (0.9 %)

Unknown

25 (0.7 %)

Total lesions

3844 (100 %)

Table 16

Approaches to tumor resection

Approaches

Cases (%)

Cervical approach

132 (3.4 %)

Right thoracotomy

3239 (84.3 %)

Left thoracotomy

66 (1.7 %)

Left thoracoabdominal approach

49 (1.3 %)

Laparotomy

148 (3.9 %)

Transhiatal thoracic esophagectomy

52 (1.4 %)

Transhiatal lower esophagectomy

92 (2.4 %)

Sternotomy

2 (0.1 %)

Others

32 (0.8 %)

Unknown

32 (0.8 %)

Total

3844 (100 %)

Table 17

Video-assisted surgery

Video-assisted surgery

Cases (%)

None

2549 (66.3 %)

Thoracoscopy

554 (14.4 %)

Laparoscopy

124 (3.2 %)

Thoracoscopy + laparoscopy

388 (10.1 %)

Mediastinoscopy

26 (0.7 %)

Thoracoscopy + laparoscopy + mediastinoscopy

4 (0.1 %)

Thoracoscopy + other

11 (0.3 %)

Laparoscopy + mediastinoscopy

5 (0.1 %)

Others

17 (0.4 %)

Unknown

166 (4.3 %)

Total

3844 (100 %)

Table 18

Fields of lymph node dissection according to the location of the tumor

Field of lymphadenectomy

Cervical

Upper thoracic

Middle thoracic

Lower thoracic

E > G

E = G

G > E

Unknown

Total

None

9 (6.6 %)

21 (4.8 %)

76 (4.3 %)

39 (3.4 %)

5 (2.0 %)

4 (9.8 %)

1 (2.9 %)

6 (75.0 %)

161 (4.2 %)

C

51 (37.2 %)

5 (1.1 %)

13 (0.7 %)

3 (0.3 %)

0 (0.0 %)

0

0

1 (12.5 %)

73 (1.9 %)

C + UM

20 (14.6 %)

5 (1.1 %)

0

0

0

0

0

0

25 (0.7 %)

C + UM + MLM

7 (5.1 %)

9 (2.1 %)

45 (2.5 %)

18 (1.6 %)

2 (0.8 %)

0

0

0 (0.0 %)

81 (2.1 %)

C + UM + MLM + A

35 (25.5 %)

286 (65.4 %)

935 (52.6 %)

435 (37.9 %)

29 (11.8 %)

3 (7.3 %)

1 (2.9 %)

8 (100.0 %)

1732 (45.1 %)

C + UM + MLM + A + other

2 (1.5 %)

4 (0.9 %)

0

1 (0.1 %)

0

0

0

0

7 (0.2 %)

C + UM + A

0 (0.0 %)

1 (0.2 %)

1 (0.1 %)

0

0

0

0

0

2 (0.1 %)

C + MLM + A

0

2 (0.5 %)

4 (0.2 %)

4 (0.3 %)

0

0

0

0

10 (0.3 %)

C + A

5 (3.6 %)

1 (0.2 %)

3 (0.2 %)

3 (0.3 %)

0

0

0

1 (12.5 %)

13 (0.3 %)

UM

0

5 (1.1 %)

4 (0.2 %)

5 (0.4 %)

0

0

0

0

14 (0.4 %)

UM + MLM

2 (1.5 %)

10 (2.3 %)

17 (1.0 %)

13 (1.1 %)

2 (0.8 %)

0

0

1 (12.5 %)

45 (1.2 %)

UM + MLM + A

0

64 (14.6 %)

584 (32.8 %)

485 (42.3 %)

81 (33.1 %)

9 (22.0 %)

5 (14.7 %)

2 (25.0 %)

1230 (32.0 %)

UM + MLM + A + other

0

0 (0.0 %)

1 (0.1 %)

0

0

0

0

0

1 (0.0 %)

UM + A

0

1 (0.2 %)

3 (0.2 %)

3 (0.3 %)

0

0

0

0

7 (0.2 %)

MLM

0

3 (0.7 %)

13 (0.7 %)

5 (0.4 %)

3 (1.2 %)

0

0

0 (0.0 %)

24 (0.6 %)

MLM + A

1 (0.7 %)

12 (2.7 %)

50 (2.8 %)

104 (9.1 %)

91 (37.1 %)

16 (39.0 %)

9 (26.5 %)

3 (37.5 %)

286 (7.4 %)

A

1 (0.7 %)

5 (1.1 %)

20 (1.1 %)

24 (2.1 %)

30 (12.2 %)

9 (22.0 %)

18 (52.9 %)

0

107 (2.8 %)

Unknown

4 (2.9 %)

3 (0.7 %)

9 (0.5 %)

5 (0.4 %)

2 (0.8 %)

0

0

3 (37.5 %)

26 (0.7 %)

Total

137 (100 %)

437 (100 %)

1778 (100 %)

1147 (100 %)

245 (100 %)

41 (100 %)

34 (100 %)

25 (100 %)

3844 (100 %)

C bilateral cervical nodes, UM upper mediastinal nodes, MLM middle-lower mediastinal nodes, A abdominal nodes

Table 19

Reconstruction route

Reconstruction route

Cases (%)

None

48 (1.2 %)

Subcutaneous

323 (8.4 %)

Retrosternal

1422 (37.0 %)

Intrathoracic

446 (11.6 %)

Posterior mediastinal

1491 (38.8 %)

Cervical

49 (1.3 %)

Others

36 (0.9 %)

Unknown

29 (0.8 %)

Total

3844 (100 %)

Table 20

Organs used for reconstruction

Organs used for reconstruction

Cases (%)

None

51 (1.3 %)

Whole stomach

102 (2.6 %)

Gastric tube

3234 (81.6 %)

Jejunum

213 (5.4 %)

Free jejunum

88 (2.2 %)

Colon

153 (3.9 %)

Free colon

12 (0.3 %)

Skin graft

0 (0.0 %)

Others

93 (2.3 %)

Unknown

18 (0.5 %)

Total organs

3964 (100 %)

Total cases

3844

Table 21

Histological classification

Histological classification

Cases (%)

Squamous cell carcinoma

3300 (86.7 %)

 Squamous cell carcinoma

685 (18.0 %)

 Well differentiated

653 (17.2 %)

 Moderately differentiated

1521 (40.0 %)

 Poorly differentiated

441 (11.6 %)

Adenocarcinoma

222 (5.8 %)

Adenosquamous cell carcinoma

35 (0.9 %)

Adenoid cystic carcinoma

1 (0.0 %)

Basaloid carcinoma

56 (1.5 %)

Neuroendocrine cell carcinoma

17 (0.4 %)

Undifferentiated carcinoma

10 (0.3 %)

Other carcinoma

9 (0.2 %)

Carcinosarcoma

21 (0.6 %)

Malignant melanoma

11 (0.3 %)

GIST

1 (0.0 %)

Other

46 (1.2 %)

Unknown

78 (2.0 %)

Total

3807 (100 %)

Table 22

Depth of tumor invasion, pT (JES 10th)

pT category

Cases (%)

pTX

24 (0.6 %)

pT0

94 (2.4 %)

pTis

29 (0.8 %)

pT1a

422 (11.0 %)

pT1b

1065 (27.7 %)

pT2

454 (11.8 %)

pT3

1518 (39.5 %)

pT4

127 (3.3 %)

pT4a

27 (0.7 %)

pT4b

30 (0.8 %)

Unknown

54 (1.4 %)

Total

3844 (100 %)

Table 23

Pathological grading of lymph node metastasis, pN (JES 10th)

Lymph node metastasis

Cases (%)

pN0

2270 (59.1 %)

pN1

492 (12.8 %)

pN2

584 (15.2 %)

pN3

225 (5.9 %)

pN4

185 (4.8 %)

Unknown

88 (2.3 %)

Total

3844 (100 %)

Table 24

Numbers of the metastatic nodes

Numbers of lymph node metastasis

Cases (%)

0

1779 (46.3 %)

1-2

985 (25.6 %)

3-6

640 (16.6 %)

7-

376 (9.8 %)

Unknown

64 (1.7 %)

Total

3844 (100 %)

Table 25

Pathological findings of distant organ metastasis, pM (JES 10th)

Distant metastasis

Cases (%)

pMX

53 (1.4 %)

pM0

3733 (97.1 %)

pM1

58 (1.5 %)

Total

3844 (100 %)

Table 26

Residual tumor, R

Residual tumor

Cases (%)

RX

156 (4.1 %)

R0

3345 (87.0 %)

R1

187 (4.9 %)

R2

156 (4.1 %)

Total

3844 (100 %)

Table 27

Causes of death

Cause of death

Cases (%)

Death due to recurrence

1139 (72.8 %)

Death due to other cancer

65 (4.2 %)

Death due to other disease (rec +)

44 (2.8 %)

Death due to other disease (rec-)

179 (11.4 %)

Death due to other disease (rec?)

7 (0.4 %)

Operative death*

39 (2.5 %)

Postoperative hospital death**

40 (2.6 %)

Unknown

52 (3.3 %)

Total of death cases

1565 (100 %)

rec recurrence

* Operative death means death within 30 days after operation in or out of hospital

** Hospital death is defined as death during the same hospitalization, regardless of department at time of death

Operative mortality after esophagectomy: 1.01 %

Hospital mortality after esophagectomy: 4.76 % Open image in new window

Notes

Acknowledgments

This study was supported by Health and Labour Sciences Research Grants for Promotion of Cancer Control Programs (H26-Cancer Policy-General-014) from the Ministry of Health, Labour and Welfare of Japan.

Compliance with ethical standards

Ethical Statement

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

All authors have nothing to disclose with regard to commercial support.

Copyright information

© The Author(s) 2016

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  • Yuji Tachimori
    • 1
  • Soji Ozawa
    • 2
  • Hodaka Numasaki
    • 3
  • Mitsuhiro Fujishiro
    • 4
  • Hisahiro Matsubara
    • 5
  • Tsuneo Oyama
    • 6
  • Masayuki Shinoda
    • 7
  • Yasushi Toh
    • 8
  • Harushi Udagawa
    • 9
  • Takashi Uno
    • 10
  • The Registration Committee for Esophageal Cancer of the Japan Esophageal Society
  1. 1.Esophageal Surgery DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Department of Gastroenterological SurgeryTokai University School of MedicineIseharaJapan
  3. 3.Department of Medical Physics and EngineeringOsaka University Graduate School of MedicineOsakaJapan
  4. 4.Department of Endoscopy and Endoscopic Surgery, Graduate School of MedicineUniversity of TokyoTokyoJapan
  5. 5.Department of Frontier Surgery, Graduate School of MedicineChiba UniversityChibaJapan
  6. 6.Department of GastroenterologySaku General HospitalNaganoJapan
  7. 7.Department of Thoracic SurgeryAichi Cancer Center HospitalAichiJapan
  8. 8.Department of Gastroenterological SurgeryNational Kyushu Cancer CenterFukuokaJapan
  9. 9.Department of Gastroenterological SurgeryToranomon HospitalTokyoJapan
  10. 10.Department of Radiology, Graduate School of MedicineChiba UniversityChibaJapan

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