Hubert J Stein1, Burkhard H A von Rahden, J Rüdiger Siewert. 1. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany. stein@nt1.chir.med.tu-muenchen.de
Abstract
BACKGROUND: Formerly an inevitably fatal disease, oesophageal cancer today has predictable chances for cure. METHODS: The recent literature and authors' own experiences in the surgical management of oesophageal cancer was reviewed to identify factors associated with improved survival after oesophagectomy. RESULTS: Currently reported overall 5-year-survival rates are reaching 40% and more in patients who have had an oesophagectomy performed with curative intention. The reasons for improved survival after surgical resection are multifactorial in nature: decreased postoperative mortality and morbidity (due to improved patient selection, surgical technique and perioperative management), the use of tailored surgical strategies (adopted to the histological tumour type, tumour location, stage of disease and the individual patient's risk profile), and multimodality treatment in patients with locally advanced disease. CONCLUSION: The prognosis of patients who have had oesophagectomy for oesophageal cancer has markedly improved during the past decades. With improved long-term survival after oesophagectomy, postoperative quality of life gains importance as an additional parameter of outcome after oesophageal cancer surgery.
BACKGROUND: Formerly an inevitably fatal disease, oesophageal cancer today has predictable chances for cure. METHODS: The recent literature and authors' own experiences in the surgical management of oesophageal cancer was reviewed to identify factors associated with improved survival after oesophagectomy. RESULTS: Currently reported overall 5-year-survival rates are reaching 40% and more in patients who have had an oesophagectomy performed with curative intention. The reasons for improved survival after surgical resection are multifactorial in nature: decreased postoperative mortality and morbidity (due to improved patient selection, surgical technique and perioperative management), the use of tailored surgical strategies (adopted to the histological tumour type, tumour location, stage of disease and the individual patient's risk profile), and multimodality treatment in patients with locally advanced disease. CONCLUSION: The prognosis of patients who have had oesophagectomy for oesophageal cancer has markedly improved during the past decades. With improved long-term survival after oesophagectomy, postoperative quality of life gains importance as an additional parameter of outcome after oesophageal cancer surgery.
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