We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Long-term results of transhiatal esophagectomy for esophageal carcinoma. A multivariate analysis of prognostic factors.
- Authors
Gertsch, Philippe; Vauthey, Jean-Nicolas; Lustenberger, Alois A.; Friedlander-Klar, Hamutal; Gertsch, P; Vauthey, J N; Lustenberger, A A; Friedlander-Klar, H
- Abstract
<bold>Background: </bold>Perioperative mortality and survival after esophagectomy have improved over the past 10 years. Although stage is the most powerful predictor of long-term survival, it remains unclear whether other factors influence prognosis.<bold>Methods: </bold>Between 1981-1991, 100 patients with esophageal carcinoma were uniformly treated by transhiatal esophagectomy without adjuvant therapy. Results and prognostic factors of long-term survival were analyzed by univariate and multivariate analyses (log-rank test and Cox regression model).<bold>Results: </bold>Forty-eight patients had severe associated medical conditions, and 26 patients were older than 69 years of age. Mortality was 3%, and morbidity was 68%. With a median follow-up of 52 months, median survival was 18 months. The overall 5-year survival was 23%, but it was 63% for early stages (pT1 + pT2). In the multivariate analysis, the risk of dying was increased by 4.9 (risk ratio) for patients with carcinomas invading beyond the muscularis propria (pT3 + pT4), compared to lower stages (pT1 + pT2) (P < 0.0001). To a lesser extent, longterm survival was also adversely affected by transfusions (packed erythrocytes) after controlling for stage (risk ratio 1.7; P = 0.047). Age (> 69 years), preoperative weight loss, tumor location, histology (adenocarcinoma versus squamous cell carcinoma), fresh frozen plasma, and splenectomy did not influence survival.<bold>Conclusion: </bold>In this study, transhiatal esophagectomy provided palliation for esophageal cancer with a low-perioperative mortality. Prolonged survival or cure was obtained for the majority of patients operated on in the early stages. Blood transfusions had a slight adverse effect on long-term survival.
- Subjects
ADENOCARCINOMA; SURVIVAL; MULTIVARIATE analysis; CANCER invasiveness; PROGNOSIS; REGRESSION analysis; TUMOR classification; DIGESTIVE organ surgery; RED blood cell transfusion; ESOPHAGEAL tumors; SQUAMOUS cell carcinoma; LONGITUDINAL method
- Publication
Cancer (0008543X), 1993, Vol 72, Issue 8, p2312
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/1097-0142(19931015)72:8<2312::AID-CNCR2820720805>3.0.CO;2-M