Strategy and Results of the Esophageal Carcinoma with a Special Reference to the Mode of Recurrence

Reiki Eguchi, Hiroko Ide, Tsutomu Nakamura, Kazuhiko Hayashi, Kazunari Yoshida, Hidemi Nakamura, Motohumi Tanaka, Fujio Hanyu, Akiyoshi Yamada*

Department of Surgery and Radiology*, Institute of Gastroenterology, Tokyo Women's Medical College

To determine whether or not multimodality treatment for esophageal cancer exerts an effect upon the mode of recurrence and postoperative results, 1033 patients who underwent esophagectomy were studied. Patients were divided into three groups: the early group (A) consisted of patients who underwent esophagectomy from 1980 to 1984; the middle group (B), from 1985 to 1989, and the late group (C), from 1990 to 1993. The later the period of esophagectomy, the greater the average of number of dissected superior mediastinal lymph nodes: 2.3 in the A group, 4.8 in the B group, 8.4 in the C group. In addition, patients who received adjuvant chemotherapy were more numerous. The survival curves of the B and C groups were better than that of the A group (p<0.001, p<0.01). The survival curve of the patients who underwent extended superior mediastinal lymphadenectomy was better than those of the others. The prognosis of the patients who received postoperative chemotherapy or irradiation was better than that of patients who received surgery alone (p<0.01). The mode of fecurrence of 224 patients in whom recurrent tumor was revealed after recurative esophagectomy did not differ according to the period of operation or the grade of the grade of upper mediastinal lymphadenectomy. The improvement of results after treatment did not have much effect upon the mode of recurrence. Because the disease-free interval of the patients who received adjuvant chemotherapy was shorter than that of patients who received surgery alone, drugs without sensitivity to cartinoma may exert an adverse effect upon prognosis.

Key words
esophageal cancer, mode of recurrence after operation for esophageal cancer, multidisiplinary treatment fer esophageal cancer

Reprint requests
Reiki Eguchi Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Sinjuku-ku, Tokyo, 162 JAPAN

Accepted
July 6, 1994

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