title: Ten-year survival of esophageal cancer after an en-bloc esophagectomy.
abstract: BACKGROUND
  Esophagectomy with gastric pull-up is the optimal treatment for patients with resectable esophageal cancer. Although the morbidity and mortality of an esophagectomy is reduced, the long-term outcome remains poor. The aim of this study was to evaluate the 10-year survival of a standardized multidisciplinary therapy concept for esophageal cancer.
  
  
  METHODS
  Between 1989 and 1999, 114 patients were treated for esophageal cancer at the University of Essen. All patients underwent an en-bloc esophagectomy with systematic lymphadenectomy. Patients with locally advanced disease (stage III) received neoadjuvant therapy. All patients were followed-up for 10 years or more or until death.
  
  
  RESULTS
  The 3-year survival was 35%, the 5-year survival 25%, and the 10-year survival was 18%. The recurrence rate was 44% with a median time of 13 months. There was no significant difference in survival between patients with locally advanced disease who received neoadjuvant therapy and patients with early disease (stadium I + II) who underwent surgery alone. Of the patients who achieved 10-year survival, 60% had locally advanced disease and received neoadjuvant therapy.
  
  
  CONCLUSIONS
  Patients with locally advanced disease, managed by a multidisciplinary treatment strategy, achieved a similar long-term survival to patients with early disease (stadium I + II).
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, University of Essen, Essen, Germany. arzu.oezcelik@uk-essen.de
authors.forename: Arzu
authors.initials: A
authors.lastname: Oezcelik
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Niebel
authors.forename: Christopher
authors.initials: C
authors.lastname: Sleyman
authors.forename: Juergen W
authors.initials: JW
authors.lastname: Treckmann
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: Renate
authors.initials: R
authors.lastname: Reinhardt
authors.forename: Tanja
authors.initials: T
authors.lastname: Trarbach
authors.forename: Eugen
authors.initials: E
authors.lastname: Malamutmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies