[Anatomo-clinical and therapeutic study of esophageal resection for cancer of the thoracic esophagus].
272 cancers of the thoracic esophagus were resected on 664 cases observed from 1975 to 1985 (resection rate: 41 p.c.): 8.1 p.c. were on the upper third, 71.3 p.c. on the middle third, 20.6 p.c. on the lower third of the esophagus. Tumors were classified as stage I (12: 4.5 p.c.), II (40: 15.2 p.c.), III (100: 37.9 p.c.), IV (112: 42.2 p.c.); 8 cases were not classified. Post-operative radiotherapy was administered to 90 patients. Hospital mortality was 50 (18.4 p.c.). Respiratory complications were the main lethal cause. After a post-operative survival of 81.6 p.c., survival at 1 year was 58.3 p.c., at 3 years 23.3 p.c., at 5 years 9.8 p.c. Actuarial survival at 5 years is 11.1 p.c. +/- 3, 17.2 p.c. for T1 and T2, 8 p.c. for T3. No advantage was noted comparing neck or intrathoracic anastomosis. Post-operative irradiation was beneficial. Factors influencing survival are staging, curative or no curative resection and post-operative irradiation for T3 N+. Nodes invasion is more important than invasion of the site of anastomosis. Palliative resections are the majority. They have no more severity than curative resections and give a 10 p.c. 5 years survival. The main effort must bear on a decrease of post-operative pulmonary complications and mortality.
Ribet
M
M
Clinique Chirurgicale Ouest, CHU de Lille.
Sobecki
L
L
Pruvot
F R
FR
Giard-Lefevre
S
S
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D013997:Time Factors
Etude anatomo-clinique et thérapeutique des résections oesophagiennes pour cancer de l'étage thoracique.