Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there was still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery
and
adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems to be rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992. Out of total 31 patients with thoracic esophageal cancer
24
cases
underwent esophagectomy with radical lymphnode dissection, and some selected patients with early esophageal cancer and other cases unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56
years.
There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%,
pneumonia
3%, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection cases(n=19) received immunotherapy. Noncurative resection cases(n=12) received postoperative immunochemotherapy, including PS-K(Copolang), CDDP, and
5-FU.
Operative survivors were followed from 4 months to 5 years. There were 3 cases lost to follow-up. Actuarial survival rate is 79% up to one year, 54% up to two years and 27% up to five years.
In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer. (Korean J Thoracic Cardiovas Surg 1994; 27:214-218)
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