[Surgical treatment of primary esophageal adenocarcinoma]

To summarize the surgical treatment and clinical bio-characteristics of primary esophageal adenocarcinoma (PEAC).

Clinical data of 43 cases with PEAC who had undergone operation from February 1980 to December 2000 in Linzhou City Esophageal Tumor Hospital were retrospectively analyzed.

Forty-three cases PEAC were reported in this study, which were 0.8% out of 5638 cases pathologically confirmed esophageal carcinoma treated during this period. Twelve cases (27.9%) were in the middle 1/3 of esophagus, thirty-one cases (72.1%) in the lower 1/3, which were significantly different from esophageal squamous cell carcinoma (ESCC). Fourteen cases were pure esophageal adenocarcinoma (32.6%), twenty-nine cases were adenosquamous cell carcinoma and adenoacanthoma cell carcinoma (67.4%). The ratio of lymph node metastasis of PEAC was higher than that of ESCC (65.1% vs. 31.6%, P < 0.001). The overall survival rates of 1, 3 and 5-year of PEAC were 81.4%, 46.5% and 28.2%, respectively, which were lower than those of ESCC (89.7%, 68.2% and 39.4%, respectively; chi 2 = 4.846, P = 0.028).

Compared with ESCC, PEAC, mainly located in the inferior 1/3 of esophagus, is a malignant disease with higher frequency of lymph node metastasis and poor prognosis. Surgical resection should be the first choice of treatment. Early diagnosis and early treatment as well as curative operation could improve prognosis. The long-term survival may be increased by adjunct multi-modality treatment.