title: Pre-operative predictive factors of early recurrence after resection of adenocarcinoma of the esophagus and cardia.
abstract: OBJECTIVE
  To determine pre-operative predictive factors of early recurrence in patients with esophageal and cardial adenocarcinoma.
  
  
  METHODS
  We retrospectively analyzed consecutive patients who underwent resection for esophageal and cardial adenocarcinoma in our institution between October 1992 and October 2001. Patient files were studied and classified according to the occurrence of early recurrence (within one year) (group A) and patients without recurrence (group B). Pre-operative clinical, biological and radiological parameters were recorded. Both groups were compared in univariate and multivariate analysis.
  
  
  RESULTS
  One hundred patients underwent surgical resection. Tumor was located in lower esophagus in 71 cases and at the cardia in 29 cases. R0 resection was feasible in 95 cases. Hospital mortality was 2%. Survival rate at 3 years was 56%. Recurrence before 1 year occurred in 28 patients (group A) and not in 72 (group B). In univariate analysis, younger age (P=0.01), dysphagia (P=0.04) and percentage of weight loss (P<0.0004) were significantly different between both groups. Weight loss more than 10% was observed in 2 patients of group B, and in 9 patients of group A. In multivariate analysis, weight loss more than 10% was the only pre-operative factor associated with early recurrence (P=0.018).
  
  
  CONCLUSIONS
  Important weight loss could be a pre-operative predictive factor of early recurrence after resection of esophageal and cardial adenocarcinoma and surgery as first line treatment could be avoided in these patients.
authors.affiliation: Département de Pathologie Digestive, Institut Mutualiste Montsouris, Paris. frederic.mal@imm.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mal
authors.forename: Thierry
authors.initials: T
authors.lastname: Perniceni
authors.forename: Hugues
authors.initials: H
authors.lastname: Levard
authors.forename: Christine
authors.initials: C
authors.lastname: Denet
authors.forename: Pierre
authors.initials: P
authors.lastname: Validire
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D002299:Cardia / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011300:Preoperative Care; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015431:Weight Loss