Surgery of squamous cell carcinoma of the esophagus

Identification of prognostic factors which may influence survival in patients with squamous cell carcinoma of the esophagus is critical for the selection of those patients who benefit from a surgical resection and the choice of the radicality of the procedure. We evaluated the tumor characteristics...

Full description

Saved in:
Bibliographic Details
Published in:Annals of oncology 1994, Vol.5, p.S1-S7
Main Authors: SIEWERT, J. R, FINK, U, BECKURTS, K. T. E, RODER, J. D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Combined Modality Therapy
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagus
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Lymph Node Excision
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Multivariate Analysis
Prognosis
Risk Factors
Survival Rate
Tumors
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Identification of prognostic factors which may influence survival in patients with squamous cell carcinoma of the esophagus is critical for the selection of those patients who benefit from a surgical resection and the choice of the radicality of the procedure. We evaluated the tumor characteristics which independently influenced survival in 249 consecutive patients with squamous cell carcinoma of the esophagus who had undergone en bloc resection and 2-field lymphadenectomy. Multivariate analysis in the entire patient population identified (1) the pT category, (2) the pN category, (3) more than 7 positive mediastinal lymph nodes, and (4) the presence of residual tumor after resection, i.e. a R1 or R2 resection, as the only independent factors influencing survival time. In a second multivariate analysis of 94 patients who survived the procedure for at least 30 days, who had a R0 resection, and who did not have preoperative neoadjuvant therapy, only the pN-category, the presence of more than 7 positive mediastinal lymph nodes, and the ratio between positive and removed mediastinal lymph nodes independently influenced survival. These data suggest that only a R0 resection, i.e. complete macroscopic and microscopic tumor removal, can increase survival in patients with squamous cell carcinoma of the esophagus. In patients with a limited number of positive mediastinal lymph nodes the prognosis may be improved by a 2-field lymphadenectomy, if the number of removed mediastinal lymph nodes exceeds the number of positive nodes by a factor of at least 5.
ISSN:0923-7534
1569-8041
DOI:10.1093/annonc/5.suppl_3.S1