4. Surgical Treatment for Cervical Esophageal Cancer

Abstract

I experienced 102 patients with cervical esophageal cancer at Keio and Kurume University Hospitals in the last 22 years. Sixty-four cases (62.7%) of them received esophagectomy and their operative mortality was 10.9%. Cervical esophagectomy was performed in 12 cases, and total esophgectomy in 52 cases. Their operative mortalities were 33.3% and 5.8% respectively. Pulmonary complications and anastomotic leakages were found very oftens in the patients with cervical esophagectomy as compared with total esophagectomy. The majority of patients with total esophagectomy could swallow food by 20 postoperative days, but no patient with cervical esophagectomy could swallow food in the same time. Remaining cancer nests in the anal stump of resected esophagus were found in 25% of the patients with cervical esophagectomy but none of the patients with total esophagectomy. The majority of patients with cervical esophagectomy died of local recurrence within 12 months after the surgery, while many patients with total esophagectomy died of lung metastasis after 12 postoperative months. Relative 5-year survival rates were 20% and 30% respectively. Based on these results such as higher curavility, lesser operative complications, earlier intake of food and relatively high survival rate, the total esophagectomy may be considered as a profitable procedure for the resection of cancer in the cervical esophagus.