Esophageal carcinoma: an analysis of 563 cases

Abstract

SUMMARY Five hundred and sixty-three patients with esophageal carcinoma were oper¬ated between September 1982 and May 1994 (356 male 207 female). Median age was 59 (range, 27 to 82) years. The localization of the tumor was cervical and esophagus superior end in 95 (16.87%) patients, upper thoracic esophagus in 59 (10.47%) patients, middle thoracic esophagus in 161 (28.59%) patients, lower tho¬racic esophagus in 137 (24.33%) patients, cardia in 111 (19.71%) patients. The histological types of tumors were epidermoid carcinoma in 432 (76.73%) patients, adenocarcinoma in 126 (22.20%) patients and metastatic or rare type carcinoma in 6 (1.06%) patients. A complete resection was performed in 340 patients through left thoracophrenotomy in 170 patients, laparatomy and right thoracotomy in 112 patients, transhiatal in 31 patients and right thoracotomy plus laparatomy and cervical incision in 27 patients. In most of the patients, stomach was used for reconstruction and colon and jejunal transposition was performed rarely. Only palliative surgical procedure was possible in 130 patients. In 93 patients only ex¬ploration was performed. Seven (1.24%) patients were in stage I, 18 (3.19%) pa¬tients in stage II, 315 (55.95%) patients in stage III and 223 (39.60%) patients in stage IV. Among the 340 patients who underwent resection 92.64% were in stage III. The postoperative anastomotic leakage occurred in 26 (6.68%) patients. Elev¬en patients (3.08%) died as a result of this anastomotic leakage. The other 17 (4.37%) patients died of cardiac and pulmonary complications giving a total mor¬tality rate of 8.23% in resected group and 4.97% all the cases.