The Annals of Thoracic Surgery, Vol 43, 176-181, Copyright © 1987 by The Society of Thoracic Surgeons
Cancer of esophagus and esophagogastric junction: analysis of results of 1,025 resections after 5 to 20 years
YK Lu, YM Li and YZ Gu
Resection was carried out in 1,025 of 1,654 patients with cancer of the
esophagus or esophagogastric junction at the Peking Medical College
Hospitals in China from 1953 through 1973. All cancers of the esophagus
were squamous cell carcinomas except for five adenocarcinomas. A lesion
localized within the esophageal wall was found in 55% and lymph node
metastasis in 41.3% of the patients undergoing resection. All cancers of
the esophagogastric junction were adenocarcinomas. The tumor had invaded
beyond the boundaries of the stomach in 76.7% of these patients, and
positive nodes were found in 61% of the patients. The rate of resectability
was 81.2% for esophageal cancer and 74% for cancer of the esophagogastric
junction. Surgical mortality after resection was 4.9% (50/1,025). The
5-year survival after resection was 20.9% (214/1,025). Better results were
found following complete resection: 24% (210/875) for all patients, 28.2%
(162/575) for patients with cancer of the esophagus, and 16% (48/300) for
patients with cancer of the esophagogastric junction. Late survival at 10,
15, and 20 years after resection of esophageal cancer was 20%, 12%, and
7.4%, respectively. The favorable prognostic factors after resection of
esophageal cancer were tumor of the lower third of the esophagus, the
absence of lymph node involvement, and the presence of a localized lesion.
The 5-year survival for patients with cancer of the lower third of the
esophagus was 32.7%. It was 64.2% for patients with a localized lesion with
negative nodes in this subgroup.
