J.Jpn. Surg. Soc.. 120(6): 646-651, 2019

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Feature topic

ESOPHAGEAL CANCER REGISTRATION

The National Clinical Database (NCD) shows that certification of training hospitals by the Japan Esophageal Society (JES) and the presence of board-certified esophageal surgeons are associated with significantly lower operative mortality rates. The operative mortality rate in hospitals performing fewer than 10 procedures per year is more than three-fold higher than that in hospitals conducting 30 or more procedures annually. Minimally invasive esophagectomy (MIE) is superior or equivalent to open esophagectomy (OE) in terms of the incidence of most postoperative morbidities and surgery-related mortality. The results suggest that MIE can replace OE in various situations from the perspective of short-term outcomes. The JES has registered cases of esophageal cancer since 1976. The survival benefit of dissection of metastases to the supraclavicular lymph nodes is indicated in patients with thoracic esophageal carcinoma. The efficacy index was calculated in each node station. For upper- and middle-esophageal tumors, the three-field approach is recommended. The survival rates of patients treated using endoscopic resection, concurrent chemoradiotherapy, and radiotherapy alone were also evaluated using the JES registry. The registration was transferred to the NCD in 2019, which allows the evaluation of not only short-term outcomes but also of the long-term survival of esophageal cancer patients based on clinical factors and treatment procedures.

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