BACKGROUND: The central element of the multimodal therapy concept for esophageal carcinomas is operative resection. This is a complex visceral surgical intervention that calls for standardized and interdisciplinary perioperative management. Continuous control of results is essential for evaluating therapy concepts. METHOD: Data of patients who had undergone thoracoabdominal resection of an esophageal carcinoma were recorded and evaluated in a prospective single center study within the framework of internal quality control. RESULTS: In the time span between 1 January 1997 and 31 December 2005, 193 patients with esophageal carcinoma were treated. Of these, 97 (50.7%) received single-stage abdominothoracal resection without neoadjuvant primary therapy. In 70% of these cases, an advanced tumor stage was present (UICC IIb or higher). R0 resection was achieved in 83 patients (85.5%). The rate of hospital mortality was found to be 6.2% (n=6). In a follow-up examination rate of 95.6%, an overall 5-year survival rate of 25% was found for all resected patients and 30% for those who received curative resection. CONCLUSION: The long-term results reached by surgery alone are comparable to those published in the current literature but are still not satisfying. A more individual approach to therapy with increased selection of patients for the application of modern neoadjuvant concepts could lead to an improvement in prognosis.
BACKGROUND: The central element of the multimodal therapy concept for esophageal carcinomas is operative resection. This is a complex visceral surgical intervention that calls for standardized and interdisciplinary perioperative management. Continuous control of results is essential for evaluating therapy concepts. METHOD: Data of patients who had undergone thoracoabdominal resection of an esophageal carcinoma were recorded and evaluated in a prospective single center study within the framework of internal quality control. RESULTS: In the time span between 1 January 1997 and 31 December 2005, 193 patients with esophageal carcinoma were treated. Of these, 97 (50.7%) received single-stage abdominothoracal resection without neoadjuvant primary therapy. In 70% of these cases, an advanced tumor stage was present (UICC IIb or higher). R0 resection was achieved in 83 patients (85.5%). The rate of hospital mortality was found to be 6.2% (n=6). In a follow-up examination rate of 95.6%, an overall 5-year survival rate of 25% was found for all resected patients and 30% for those who received curative resection. CONCLUSION: The long-term results reached by surgery alone are comparable to those published in the current literature but are still not satisfying. A more individual approach to therapy with increased selection of patients for the application of modern neoadjuvant concepts could lead to an improvement in prognosis.