[5-year survival after subtotal extensive esophagectomy for cancer]

Over a seven year period, subtotal esophagectomy for cancer was performed on 125 patients (79.6% of the referred patients). Resection was potentially curative in 92, and it was palliative in 33. Potentially curative esophagectomies were carried out either by right thoracotomy, cervicotomy and laparotomy (n = 77), by combined transhiatal and transcervical approach without formal thoracotomy (n = 14), or by median sternotomy, cervicotomy and laparotomy (n = 1) depending on the tumor location in the esophagus and the general status of the patient. It included resection of the esophagus itself, and the lymph nodes and adjacent soft tissues located in the posterior mediastinum from the apex of the chest down to the diaphragm in patients operated on by right thoracotomy, in the posterior inferior mediastinum from the pulmonary veins down to the hiatus in those operated on by a transhiatal approach, and in the upper and lower mediastinum in those operated on transsternally. Twenty-eight patients operated on by potentially curative esophagectomy were given adjuvant radiotherapy or radiochemotherapy. Thirty-day and in-hospital postoperative mortalities were 0 and 2.4% (3/125), respectively. Five-year actuarial survival was 30% in the whole series, and 41% after potentially curative resection. In the latter instance, it was 48% for adenocarcinomas v.s. 38% for squamous cell carcinomas (p > 0.05), 38% after transthoracic resection v.s. 61% after transhiatal resection (p > 0.05), 44% after surgery alone v.s. 38% after surgery plus adjuvant therapy (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)