RESULTS OF ESOPHAGEAL CANCER-SURGERY

From 1. 10. 1972 until 1. 1. 1993 176 patients underwent esophageal resection for cancer of the esophagus. There were 72,7 % squamous cell carcinomas and 24,4 % adenocarcinomas. pTNM staging was as follows: Stage I: 7,3 %; stage IIa: 33,5 %; stage IIb: 11,9 % and stage III 47,1 %. The resection was performed in 92,6 % by an abdominothoracic approach. Reconstruction was usually performed by transposition of the stomach. Only in 8 patients colon was used for esophageal replacement. The complication rate was 34,6 %, mainly pulmonary complications were seen. The rate of anastomotic insufficiency was 6,2 %. Hospital mortality was 15,3 %, but decreased from 29,1 % in the years 1972-1982 to 10,1 % in the last decade. There was a significant correlation between the 5-year-survival-rate and the tumor staging respectively the lymph node involvement. The long-term results showed a relatively high percentage of reflux complaints and persistant dysphagia. But the general condition and quality of life were considered subjectively by 53,5 % as good and by 42,8 % as moderate. From these results it can be concluded, that surgery today offers the best chances for potential cure and a high quality of life.