Oesophagectomy for carcinoma of the oesophagus and oesophagogastric junction

OBJECTIVE: Oesophageal carcinoma has a poor prognosis; surgical resection remains the only chance of cure but is still associated with a significant morbidity and mortality. The aim of this study was to review the results of one surgeon for oesophageal resection for carcinoma of the oesophagus and oesophagogastric junction over a 23 year period. METHODS: Between January 1974 and December 1996, 591 patients (408 males; 183 females; mean age 66 years) underwent an oesophageal resection for carcinoma of the oesophagus or oesophagogastric junction. RESULTS: In hospital mortality was 8.8% (52/591). This has decreased to less than 5% for resections between 1985 and 1996. Non-fatal complications occurred in 21% of patients (123/591). Survival, including in hospital mortality (+/-SEM), was 53.98% (+/-2), 31.77% (+/-2) and 15.3% (+/-2) at 1, 2 and 5 years respectively. CONCLUSION: Early mortality following oesophageal resection has fallen in recent years. Despite considerable experience, long term survival remains disappointingly low.