[Primary esophageal adenocarcinoma].
OBJECTIVE
To study the clinical biocharacteristics of primary esophageal adenocarcinoma (PEAC) and factors influencing patients' prognosis and to find reasonable surgical indications and combined therapy.


METHODS
To analyse the clinical materials of 106 patients with PEAC undergone operation compared with those of patients with esophageal squamous-cell carcinoma (ESCC).


RESULTS
The overall resectability, morbidity and 30-day mortality rate of PEAC was 92.5%, 23.5% and 2.8% respectively, similar to those of ESCC. The TNM staging, lymph node metastasis, extraesophageal invasion and types of operation were the major determinants influencing long-term prognosis. The 5-year survival rate of PEAC was 21.0%, which was lower than that of ESCC(P < 0.01). Metastasis or recurrence remained to be the cause of death in 82.4% of patients who lived longer than 5 years, which was higher than that of ESCC(P < 0.01). Adjuvant radiation did not influence survival of the patients with lymph node metastasis, but appeared helpful to the patients with no lymph node metastasis.


CONCLUSIONS
Compared with ESCC, PEAC is a malignent disease with poor prognosis. Surgical resection is the first and chief choice of treatment. Surgical indications include patients in stage 0, I, II and some in stage III and even in stage IV of PEAC. Early diagnosis and early treatment as well as curative operation could improve prognosis. Adjuvant radiation therapy appeares helpful only to the patients without lymph node metastasis.
Department of Thoracic Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing.
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Wang
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Zhang
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Zhang
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D004938:Esophageal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate