Patients vivants à 5 ans après œsophagectomie curative pour cancer

Abstract

Aim of the study. – To analyse the clinical and pathological parameters of 5–year survival patients after curative oesophageal resection for cancer and to identify factors predictive of long-term survival. Methods. – The data of 370 patients who underwent oesophagectomy with curative intent from January 1982 for oesophageal squamous cell carcinoma ( n = 320) or adenocarcinoma ( n = 50) were reviewed. After excluding postoperative deaths ( n = 20), these patients were surviving (S group, n = 113) or dead (NS group, n = 237) with a 60–month follow-up. Uni– and multivariate analysis allowed comparison between the two groups. Results. – Postoperative mortality and morbidity rates were 4.0% and 37.6%, respectively. Parameters related to 5–year survival were: absence of preoperative malnutrition or dysphagia, transhiatal resection, no reoperation, limited tumour, histological response to neoadjuvant treatment, absence of lymph node capsular invasion, number of invaded lymph nodes ≤ 4, invaded lymph node ratio ≤ 0.1, absence of tumour recurrence or metachronous primary cancer. On multivariate analysis, factors predictive of 5–year survival were: absence of preoperative dysphagia ( P < 0.001), stage 0-I-IIA tumour ( P<0.001) and absence of metachronous cancer ( P = 0.016). Conclusion. – Complete surgical resection allows 5–year survival. Factors predictive of long-term survival assessed in preoperative evaluation, dysphagia and tumour stage, should be useful to select patients for neoadjuvant treatment.