%0 Journal Article
%T Long-term survival from adenocarcinoma of the esophagus after transthoracic and transhiatal esophagectomy
%A Kjell K Ovrebo
%A Stein A Lie
%A Ole D Laerum
%A Knut Svanes
%A Asgaut Viste
%J World Journal of Surgical Oncology
%D 2012
%I BioMed Central
%R 10.1186/1477-7819-10-130
%X A cohort of 147 consecutive patients with adenocarcinoma of the esophagus was evaluated for esophagectomy between 1984 and 2000. The patients were followed prospectively and observed survival rates of patients with a transthoracic or transhiatal approach to esophagectomy were compared by standardized mortality ratio (SMR) and relative mortality ratio (RMR) using the expected survival of a matched Norwegian population.A R0 resection was performed by transthoracic (nˋ=ˋ33) or a transhiatal (nˋ=ˋ55) esophagectomy in 88 (60%) patients with a median age of 61 (range: 35每77) and 70 (42每88) years, respectively (P <0.001). Tumor stages and other possible risk factors were similar in the two groups. Transthoracic or transhiatal esophagectomy resulted in a median survival time of 20.5 (95% confidence interval (CI): 10.4每57.6) and 16.4 (10.6每28.7) months, respectively. The respective survival rates were 31.2% and 27.8% by 5 years, and 21.3% and 16.6% by 10 years with an overall RMR of 1.14 (Pˋ=ˋ0.63). Median survival time in the absence or presence of lymph node metastases was 74.0 (95% CI: 17.5每166.4) and 10.7 (7.9每14.9) months. The corresponding survival rates by 10 years with non-involved or involved nodes were 48.9% and 3.8% respectively (RMR 2.22, Pˋ=ˋ0.007). Patients with a pT1-tumor were few and the survival rate was not very different from that of the general population (SMRˋ=ˋ1.7, 95% CI: 0.7每4.1). The median survival time of patients with a pT2-tumor was 30.4 (95% CI: 9.0每142) months and with a pT3-tumor 14 (9.2每16.4) months. The survival rates by 10 years among patients with a pT1 tumor were 57.0% (95% CI: 14.9每78.9), pT2 33.3% (11.8每52.2), and pT3 7.1% (1.9每15.5). The relative mortality for T3 stages compared to T1 stages was statistically significant (RMRˋ=ˋ3.22, Pˋ=ˋ0.024).Transthoracic and transhiatal esophagectomy are both effective approaches for treatment of adenocarcinoma of the esophagus and survival of more than 10 years can be expected without adjuvant ch
%U http://www.wjso.com/content/10/1/130/abstract