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Ann Thorac Surg 1995;59:173-177
© 1995 The Society of Thoracic Surgeons

Can Esophagectomy Cure Cancer of the Thoracic Esophagus Involving the Major Airways?

Toshiki Matsubara, MD, Mamoru Ueda, MD, Toshifusa Nakajima, MD, Ken Nakagawa, MD, Takashi Yamashita, MD, Noboru Horikoshi, MD, Akio Yanagisawa, MD

Departments of Surgery, Radiology, Medical Oncology, and Pathology, Cancer Institute Hospital, Tokyo, Japan

Accepted for publication August 18, 1994.

To evaluate the effects of aggressive operation for esophageal cancer invading the trachea and main bronchi, we investigated retrospectively 62 patients with proven tracheobronchial involvement who underwent thoracotomy for esophagectomy between 1973 and 1993. We operated unless the tumor was assessed to be definitely unresectable. Esophagectomy was possible in 55 patients, and the resectability rate was 95% after preoperative computed tomography and bronchoscopy became routine. After esophagectomy, no residual cancer lesion was recognizable macroscopically in 53% of patients. The hospital mortality rate in esophagectomy cases was 7% in the past 8 years. The outcome in patients who underwent curative resection was significantly favorable (p < 0.0001), and the 2-year survival was 51%. The patients with nonresectable cancer all died within 6 months compared with a 23% 1-year survival rate for palliative esophagectomy cases (p < 0.006). Among patients with tracheobronchial involvement assessed as resectable on computed tomography and bronchoscopy, a considerable proportion benefited from aggressive therapy with esophagectomy. The possibility of complete cure was high, especially when the cancer responded well to preoperative therapy and no lymph nodes were involved.






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