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Improved Surgical Results in Thoracic Esophageal Squamous Cell Carcinoma: A 40-year Analysis of 792 Patients

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Journal of Gastrointestinal Surgery

Abstract

Extensive lymphadenectomy, including upper mediastinum, for thoracic esophageal carcinoma was introduced at the beginning of 1980s. However, the efficacy has not been analyzed in large series at a single institute. We evaluated factors potentially related to improved surgical results in patients with thoracic esophageal squamous cell carcinoma (SCC). From 1959 to 1998, a total of 792 patients with thoracic esophageal SCC underwent R0 surgery. A variety of clinicopathological factors were compared among patients treated from 1990 to 1998 (recent group, n = 164) and 1959 to 1989 (former group, n = 628). The recent group showed significantly better survival than the former group (5-year survival rates: 51 versus 17%, P < 0.01), partly because earlier stage disease was included in the recent group than in the former group. Multivariable analysis, using the Cox regression analysis, indicated the time period of surgery, age, tumor location, the number of positive nodes (>5), venous invasion, and tumor–node–metastasis stage. Upper mediastinum lymphadenectomy was also an independent factor to improve survival of patients with thoracic esophageal SCC.

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Abbreviations

SCC:

squamous cell carcinoma

UMLD:

upper mediastinum lymphadenectomy

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Acknowledgment

This work was supported in part by a grant-in-aid from the Ministry of Education, Science and Culture of Japan (21st Century Center of Excellence Program).

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Authors and Affiliations

  1. Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuuou-ku, Chiba, 260-8670, Japan

    Hideaki Shimada, Hisahiro Matsubara, Shinichi Okazumi, Kaichi Isono & Takenori Ochiai

Authors
  1. Hideaki Shimada
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  2. Hisahiro Matsubara
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  3. Shinichi Okazumi
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  4. Kaichi Isono
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  5. Takenori Ochiai
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Corresponding author

Correspondence to Hideaki Shimada.

Additional information

Based on multivariate analysis of 792 cases during 40-years experience on thoracic esophageal cancer surgery at Chiba University Hospital, upper mediastinum lymphadenectomy was found to be one of the independent prognostic factors to improve patient’s overall survival.

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Shimada, H., Matsubara, H., Okazumi, S. et al. Improved Surgical Results in Thoracic Esophageal Squamous Cell Carcinoma: A 40-year Analysis of 792 Patients. J Gastrointest Surg 12, 518–526 (2008). https://doi.org/10.1007/s11605-007-0280-2

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  • DOI: https://doi.org/10.1007/s11605-007-0280-2

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