Radical esophagectomy for esophageal cancer: results in Thai patients.
BACKGROUND
Radical esophagectomy was reported to have prolonged survival in patients with esophageal cancer However, it is associated with high morbidity and mortality. Controversy still exists regarding value of radical esophagectomy


METHODS
The authors analyzed the results, including complications and survival in 68 consecutive patients with esophageal cancer who were treated with transthoracic radical esophagectomy at the Department of Surgery, Siriraj hospital, Mahidol University between June 2002 and June 2008.


RESULTS
There were 57 males and eight females with a mean age of 59.28 +/- 11.25 years. Regarding T staging, 81.5% of the patients were in T3 stage while 1.5% of the patients had Ti stage, 15.4% had T2 stage, and 1.5% had T4 stage. Lymph node metastasis (NI) was found in 63.1% of the patients and NO was in 36.9%. Most of the patients were in advanced stages with 53.8% in stage III, 44.6% in stage II, and 1.5% in stage I. The 5-year survival rate of the patients with node positive was significantly lower than the patients with node negative (p = 0.018). The survival was significantly better in stage Ilcompared to stage III (p = 0.012). Overall 5-year survival rate was 28. 5%. Most common complications were from pulmonary causes (22.1%), anastomotic leakage (8.8%), and wound infection (8.8%). Mortality rate was 4.41%.


CONCLUSIONS
Radical esophagectomy was associated with relatively low mortality and acceptable survival. It should be considered in surgical treatment of patients with esophageal cancer
Division of General Surgery, Department ofSurgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. teams@mahidol.ac.th
Asada
A
Methasate
Atthaphorn
A
Trakarnsanga
Thawatchai
T
Akaraviputh
Vitoon
V
Chinsawangwathanakol
Darin
D
Lohsiriwat
D000328:Adult; D000368:Aged; D044466:Asian People; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D016019:Survival Analysis; D015996:Survival Rate; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome