J.Jpn. Surg. Soc.. 91(9): 1223-1226, 1990

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Report on the annual meeting

SURGICAL TREATMENT AND THE RESULTS FOR THE PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE LOWER ESOPHAGUS AND CARDIA

One hundred and ninety-nine patients who received esophagectomy for squamous cell carcinoma of the lower esophagus and cardia were analyzed. Twenty-five lesions (12.5%) were limited within the submucosa. Twenty-three patients whose lesions were diagnosed to have invasion to the surrounding organs received esophagectomy combined with the resection of the lung, pericardium, diaphragm, liver or pancreas. Five-year survival rate for these 23 patients was 22.6%. One hundred and thirty patients (65.3%) had positive nodes in the resected specimen. Neck and paracardiac nodes were the most frequent site of metastasis (36.0% and 37.3%), and 17.8% of them were metastasis positive in the lower periesophageal nodes. Recurrent disease was identified in 79 patients. Thirteen recurrences occurred in the neck lymph nodes, seven in the mediastinal, and ten in the abdominal lymph nodes. Overall 5-year survival rate was 30.1%. Three-year survival rate for 25 patients who received esophagectomy with wide lymph node dissection of the neck, mediastinum and abdomen was 57.2%. Five-year survival rate for the 11 patients who had positive nodes in the neck was 61.9%. A radical esophagectomy with neck lymph node dissection will improve the outcome of the patient with squamous cell carcinoma in the lower esophagus and cardia.

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