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KMID : 0364020070400100685
Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 10 p.685 ~ p.690
The Role of Surgery for the Treatment of Upper Esophageal Cancer
Park Jae-Kil

Sa Young-Jo
Nam Sang-Yong
Park Kuhn
Abstract
Background:In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaken to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery.

Materials and methods: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 124 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival.

Results:On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of postoperative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p£¼0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy.

Conclusions:There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required. (Korean J Thorac Cardiovasc Surg 2007;40:685-690)
KEYWORD
Esophageal neoplasms, Esophageal surgery
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