Radical Esophagectomy for Esophageal Cancer: Results in Thai Patients
Asada Methasate MD, PhD*, Atthaphorn Trakarnsanga MD*, Thawatchai Akaraviputh MD*, Vitoon Chinsawangwathanakol MD, PhD*, Darin Lohsiriwat MD*
Affiliation : * Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Radical esophagectomy was reported to have prolonged survival in patients with esophageal cancer. However,
it is associated with high morbidity and mortality. Controversy still exists regarding value of radical esophagectomy.
Material and Method: The authors analyzed the results, including complications and survival in 68 consecutive patients with
esophageal cancer who were treated with transthoracic radical esophagectomy at the Department of Surgery, Siriraj hospital,
Mahidol University between June 2002 and June 2008.
Results : There were 57 males and eight females with a mean age of 59.28 + 11.25 years. Regarding T staging, 81.5% of the
patients were in T3 stage while 1.5% of the patients had T1 stage, 15.4% had T2 stage, and 1.5% had T4 stage. Lymph node
metastasis (N1) was found in 63.1% of the patients and N0 was in 36.9%. Most of the patients were in advanced stages with
53.8% in stage III, 44.6% in stage II, and 1.5% in stage I. The 5-year survival rate of the patients with node positive was
significantly lower than the patients with node negative (p = 0.018). The survival was significantly better in stage II compared
to stage III (p = 0.012). Overall 5-year survival rate was 28.5%. Most common complications were from pulmonary causes
(22.1%), anastomotic leakage (8.8%), and wound infection (8.8%). Mortality rate was 4.41%.
Conclusion : Radical esophagectomy was associated with relatively low mortality and acceptable survival. It should be
considered in surgical treatment of patients with esophageal cancer.
Keywords : Radical esophagectomy, Esophageal cancer, Lymph node dissection
