Total Esophagectomy versus Proximal Esophagectomy for Esophageal Cancer at the Cervicothoracic Junction

• Published in: World journal of surgery 1999-05, Vol.23 (5), p.486-491
• Main Authors: Fujita, Hiromasa, Kakegawa, Teruo, Yamana, Hideaki, Sueyoshi, Susumu, Hikita, Shigeki, Mine, Takashi, Tanaka, Yuichi, Ishikawa, Hiroto, Shirouzu, Kazuo, Mori, Kazunori, Inoue, Yojiro, Tanabe, Hiroko Yanaga, Kiyokawa, Kensuke, Tai, Yoshiaki, Inutsuka, Hiroki
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Chi-Square Distribution; Esophageal Neoplasms - surgery; Esophagectomy - methods; Esophagus; Female; Humans; Laryngectomy; Lymph Node; Lymph Node Excision; Male; Medical sciences; Middle Aged; Mortality Rate; Multivariate Analysis; Neoplasm Recurrence, Local; Postoperative Complications; Prognostic Factor; Proportional Hazards Models; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Treatment Outcome
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/PL00012336

. To investigate the adequate extent of esophagectomy and lymphadenectomy for an esophageal cancer localized at the cervicothoracic junction, the mortality and morbidity rates, survival rates, and patterns of recurrence were retrospectively analyzed in two groups—14 patients who underwent total esophagectomy with or without laryngectomy and 15 patients who underwent proximal esophagectomy with or without laryngectomy—at Kurume University Hospital from 1981 to 1996. Proximal esophagectomy with or without laryngectomy resulted in a lower hospital mortality rate and better overall survival for patients who underwent curative esophagectomy compared with total esophagectomy with or without laryngectomy. Multivariate analysis indicated that the extent of esophagectomy (total esophagectomy versus proximal esophagectomy) was not a prognostic factor. The incidence of recurrence was not different between the two groups. Lymph node metastasis or recurrence from such esophageal cancers was localized to the neck and upper mediastinum. For an esophageal cancer localized at the cervicothoracic junction, therefore, proximal esophagectomy with or without laryngectomy and with cervical and upper mediastinal lymphadenectomy could be better indicated for preselected patients.