Esophageal cancer patients surviving 6 years after esophagectomy.
BACKGROUND
Esophageal cancer is one of the most malignant tumors, with a dismal prognosis in spite of recent advances in early diagnosis and extended lymphadenectomy. These patients need to be stratified according to prognostic variables for precise identification of high-risk group.


METHODS
Seventy-six patients with esophageal carcinoma were uniformly treated with curative intent between 1980 and 1992 with at least 6 years follow-up. Results and prognostic factors of long-term survival were analyzed by univariate and multivariate analyses.


RESULTS
Thirty patients (39.5%) survived 6 years, and the remaining 46 patients died within 6 years: recurrent esophageal cancer in 27 and causes unrelated to esophageal cancer in 19. The 1-, 2-, 3-, and 6-year overall survival rates in all 76 patients were 77.6%, 57.9%, 53.9%, and 39.5%, respectively. The factors influencing survival rate verified by univariate analysis were Borrmann classification (0, 1 vs. 2, 3), size of tumor (< or =3.0 vs. >3.0 cm), depth of invasion (T1, 2 vs. T3, 4), pN category (pN0 vs. pN1), number of lymph node metastasis (< or =4vs. >4), metastatic lymph node ratio (< or =0.1 vs. >0.1), time of operation (< or =480 vs. >480 min), and amount of perioperative blood transfusion given (< or =2 vs. >2 U). Among the significant variables independent prognostic factors for survival determined by multivariate analysis were metastatic lymph node ratio and amount of blood transfusion.


CONCLUSIONS
A significant number of patients can thus apparently be cured of esophageal carcinoma by extensive resection. Patients with many metastatic lymph nodes and much blood transfusion, on the other hand, should receive appropriate treatment against such esophageal carcinoma.
Second Department of Surgery, Shimane Medical University, Enya-cho 89-1, Izumo 693-8501, Japan. nigeka35@shimane-med.ac.jp
Mitsuo
M
Tachibana
Dipok Kumar
DK
Dhar
Shoichi
S
Kinugasa
Hiroshi
H
Yoshimura
Toshiyuki
T
Fujii
Muneaki
M
Shibakita
Satoshi
S
Ohno
Shuhei
S
Ueda
Hitoshi
H
Kohno
Naofumi
N
Nagasue
D000368:Aged; D001803:Blood Transfusion; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis