Schumpelick V, Fass J, Truong S, Dreuw B, Treutner K H
Chirurgische Klinik, Medizinische Fakultät, RWTH Aachen.
Chirurg. 1992 Sep;63(9):715-21.
204 patients were treated for esophageal cancer from 1.1.1986 until 1.6.1992 (carcinoma of the hypopharynx: n = 12, adenocarcinoma of the endobrachyesophagus: n = 82, primary esophageal cancer: n = 110). Out of the primary esophageal cancers 84 tumors (76%) were resected and 24% had palliative endoscopic and/or irradiation therapy. The stage distribution of the resected patients was: stage I: 7.1%, stage IIa: 35.7%, stage IIb: 11.9%, stage III: 33.3%, stage IV: 11.9%. The total morbidity of the resected patients amounted to 32.1%, the 30 days mortality to 7.1%, and the in hospital mortality to 9%. These data show no significant difference to the results of palliative endoscopic procedures (morbidity: 42.3%, mortality: 7.7%). None of the conservatively treated patients survived longer than 12 months whereas resected individuals had a 5-year-survival rate of 20%. The most predictive factors for prognosis were: Depth of tumor invasion (p less than 0.01), R-classification (p less than 0.05), and the lymphonodular status (p less than 0.05). A perioperative irradiation was effective in T3- and T4-tumors.