[Long-term survival after curative resection for oesophageal and cardia cancer]

We present the long-term survival after curative resection for cancer at the gastro-oesophageal junction.

From 1992 through 2003, 147 patients with cancer at the gastro-oesophageal junction underwent curative resection. Preoperative evaluation included a computed tomography (CT) scan of the thorax and abdomen, gastroscopy, endoscopic ultrasonography and ultrasonography of the neck.

Explorative laparotomy was performed in 466 patients, and 147 underwent curative resection, while 319 had advanced disease. No patients received adjuvant chemo-radiotherapy. Adenocarcinoma was found in 93% of the patients and squamous cell carcinoma in 7%. Cardia resection was performed in 78%, while 22% underwent gastrectomy. R0 resection was performed in 95% of the operations. Anastomotic dehiscence was seen in 4%. The perioperative mortality after curative resection was 3% and the 180-day-mortality was 5%. The observed five-year survival rate after curative operation was 29% and the estimated five-year survival was 24%. The five-year survival rates according to tumour stage (T1-4) were 85%, 40%, 23% and 25%, respectively. After stratification according to lymph node metastases (-/+metastases) and age below/above 70 years, five-year survival rates were 41%/ 19% and 32%/17%, respectively. Cox regression analysis showed that no metastases (N0) and age below 70 years were independent predictors of survival.

The overall and stage-dependent survival after five years, perioperative mortality and complications are acceptable and comparative to those reported by foreign centres.