The researchers examined the efficacy of the Ivor Lewis esophagogastrectomy for esophageal carcinoma, prior to the widespread use of preoperative chemotherapy and irradiation.
They reported their findings in the June issue of Annals of Thoracic Surgery.
|Post-surgical 5-year survival rates:|
Stage 0 : 80%
Stage I: 94%
Stage IIa: 36%
Stage IIb: 14%
Stage III: 10%
Stage IV: 0%
|Annals of Thoracic Surgery|
The cases of 220 (196 men; median age, 65 years) consecutive patients, who underwent an Ivor Lewis esophagogastrectomy for esophageal cancer between 1992 and 1995, were re-examined.
The results of pathological study showed adenocarcinoma in 188 patients (86%), squamous cell carcinoma in 31 (14%), and leiomyosarcoma in 1 patient (0.5%).
Post-surgical staging was also conducted: 10 patients were found to be stage 0; 19 were stage I; 38 were stage IIa; 28 stage IIb; 111 stage III; and 14 stage IV.
The researchers found that the operative mortality rate was 1.4% (3 patients), and complications occurred in 83 patients (38%).
Median survival for operative survivors was 1.9 years (range, 32 days to 8.7 years).
The overall 5-year survival rate was found to be 25%. It was 80% for patients in stage 0, 94% for those in stage I, 36% for stage IIa, 14% for stage IIb, 10% for stage III, and 0% for patients in stage IV.
Dr Antonio L. Visbal, of the Mayo Clinic, Rochester, Minnesota, concluded on behalf of the team, "Ivor Lewis esophagogastrectomy for esophageal cancer is a safe operation.
"Long-term survival is stage-dependent. The low survival associated with advanced cancers should stimulate the search for effective neoadjuvant therapy."