title: Transhiatal and transthoracic esophagectomy for adenocarcinoma of the esophagus.
abstract: Adenocarcinoma of the esophagus is no longer rare and is treated by resection. To determine whether the approach used for resection influences outcome, we studied 88 patients who underwent resection; 14 had stage I or II disease, 74 had stage III, and 40 had stage IV. One third of those with Barrett's esophagus were noted on screening endoscopy to have potentially curable disease; the others were diagnosed with stage III or IV disease. Transhiatal esophagectomy was performed in 63 patients; 24 patients underwent transthoracic esophagectomy. We found no difference in survival or morbidity between transhiatal and transthoracic esophagectomy. Overall 5-year survival for stage I and II disease was 86%. For stage III and IV disease, 5-year survival was 14.5%. Aggressive surveillance of Barrett's esophagus facilitates the discovery of early disease. Esophagectomy for adenocarcinoma can result in cure of early cancers and improved palliation of more advanced disease.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee 53226.
authors.forename: M R
authors.initials: MR
authors.lastname: Moon
authors.forename: W J
authors.initials: WJ
authors.lastname: Schulte
authors.forename: G B
authors.initials: GB
authors.lastname: Haasler
authors.forename: R E
authors.initials: RE
authors.lastname: Condon
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D061224:Laryngeal Nerve Injuries; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009367:Neoplasm Staging; D015996:Survival Rate