INTRODUCTION:Treatment of oesophageal cancer with curative intent requires a multidisciplinary approach. Neoadjuvant therapy, the radicality of resection and extension of lymphadenectomy have been associated with increased operative morbidity and mortality. The aim of this study was to assess the results of surgical treatment of oesophageal cancer since the presence of an interdisciplinary esophagogastric tumour board. METHODS:Patients with cancer of the oesophagus and oesophagogastric junction who underwent oesophagectomy between January 2005 and March 2012 were included in this retrospective study. Data concerning type of resection, postoperative complications, mortality and survival were analysed. RESULTS:Of the 392 patients with a diagnosis of oesophageal cancer over the study period, 100 underwent oesophagectomy. Seventy-four patients received neoadjuvant treatment. Eighty-two patients underwent transthoracic resection while a transhiatal was used in 10 patients. Colon interposition was required in 8 cases. An R0 resection was achieved in 98 patients. Anastomotic leaks developed in 15 patients, 9 were intrathoracic and 6 were cervical. Postoperative morbidity occurred in 42% of patients, and intra-hospital and 90-day mortality was 2%. Median length of hospital stay was 16 days. The respective actuarial survival at 1 and 5 years were 82% and 56%. CONCLUSIONS:Surgical treatment with curative intention for oesophageal cancer is only possible in a quarter of patients diagnosed. The high morbidity rate was mainly due to intrathoracic complications.

译文

简介:具有治愈意图的食管癌治疗需要多学科的方法。新辅助疗法,淋巴结清扫术的彻底切除和扩展与手术发病率和死亡率增加相关。这项研究的目的是评估由于跨学科食管胃肿瘤委员会的存在而对食道癌进行外科治疗的结果。
方法:这项回顾性研究纳入了2005年1月至2012年3月间接受食管切除术的食道和食管胃交界处的癌症患者。分析了有关切除类型,术后并发症,死亡率和生存率的数据。
结果:在本研究期间的392例诊断为食道癌的患者中,有100例接受了食管切除术。 74例患者接受了新辅助治疗。 82例患者行了胸腔切除术,而10例患者使用了经食管切开术。 8例需要插入结肠。 98例患者完成了R0切除术。 15例患者发生吻合口漏,胸腔内漏9例,颈椎漏6例。术后发病率发生在42%的患者中,院内死亡率和90天死亡率为2%。住院时间中位数为16天。 1年和5年的精算生存率分别为82%和56%。
结论:只有四分之一的被诊断患者可以进行具有食管癌根治性的手术治疗。高发病率主要归因于胸腔内并发症。

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