Advances in esophageal cancer surgery in Japan: An analysis of 1000 consecutive patients treated at a single institute

Masaru Morita, Rintaro Yoshida, Keisuke Ikeda, Akinori Egashira, Eiji Oki, Noriaki Sadanaga, Yoshihiro Kakeji, Takeharu Yamanaka, Yoshihiko Maehara

研究成果: ジャーナルへの寄稿記事

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Background: In Japan, most esophageal cancers are squamous cell carcinomas, and the results of esophagectomy have improved remarkably in recent years. The object of this study was to evaluate advances in operative therapy for esophageal cancer in Japan. Method: We evaluated mortality, morbidity, and prognosis in 1000 consecutive patients who underwent esophagectomy for esophageal cancer at a single institution in Japan. The patients were divided into 3 groups according to the period when esophagectomy was performed: Group I (n = 197), 1964-1980; group II (n = 432), 1981-1993; and group III (n = 371), 1993-2006. Results: The incidence of squamous cell carcinoma was 94%. The morbidity rates were 62%, 38%, and 33 %, in groups I, II, and III, respectively (P < 0.01, groups I vs II and III), and the in-hospital mortality rates were 14.2%, 5.1%, and 2.4%, respectively (P < 0.01, between each group). The 5-year overall survival rate was 30% (14%, 27%, and 46% in groups I, II, and III, respectively; P < 0.0001). Multivariate analysis revealed age, gender, depth of invasion, node metastasis, distant metastasis, curability, extent of lymphadenectomy, resectability, and the period when the operation was performed as independent prognostic factors. Conclusion: Generally, esophagectomy has been performed safely without critical complications; however, the prognosis has improved remarkably with advances in surgical techniques and treatment modalities.

元の言語英語
ページ(範囲)499-508
ページ数10
ジャーナルSurgery
143
発行部数4
DOI
出版物ステータス出版済み - 4 1 2008

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All Science Journal Classification (ASJC) codes

  • Surgery

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