Operable esophageal carcinoma: current results from Hong Kong

Over an 11-year period 1158 patients with esophageal cancers were managed by the Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 857 (74.0%) of whom had confirmed squamous cell carcinoma. Operation was carried out in 76.5% of patients: 25.4% underwent curative resection, 36.2% underwent palliative resection, 13.8% had bypass operations, and 1.2% had a simple exploration. In the resection group, the mean age was 62.6 years with a strong male predominance of 6.4:1.0. Most patients were heavy smokers and heavy drinkers; 27.9% had increased pulmonary risks, and 8.3% had increased cardiac risks for resection. Most (56%) of the tumors were located in the middle third of the esophagus; 70.4% of patients had operative stage III disease, and 7.2% had stage IV disease. The 30-day mortality and hospital mortality after resection were 4.9% and 15.9%, respectively. The primary cause of 30-day mortality was cardiopulmonary-related complications (65.2%), and the commonest causes for hospital deaths were from pulmonary complications (40.0%) and advancing malignancy (23.6%). The median survivals for stages I, IIA, IIB, III, and IV were 83.5, 24.3, 37.8, 8.6, and 5.0 months, respectively. Of the survivors, at 1, 6, and 12 postoperative months, respectively, 63%, 76%, and 83% of patients were able to take a full solid meal similar to the normal diet consumed before their disease.