Outcomes of oesophagectomy for carcinoma: one institution experience and analysis of 126 patients

We present the short and long term outcomes of patients undergone oesophagectomy for malignat tumors, at the Department of Surgical Sciences of the University of Insubria. 126 patients undergone surgical resection for different oesophageal tumors: squamous cell carcinoma (69%), adenocarcinoma (26%), other histotypes (5%). The type of resection performed was: total oesophagectomy (18%), sub-total oesophagectomy in (66%), laringopharingo-oesophagectomy (14%) and miscellanea (2%). Laparo-thoracotomic approach has been used in 59% of the cases, while, in the remaining 41% of the patients a trans-hiatal (32%) or three stages (9%) procedures were preferred. Peri-operative mortality and morbidity rate was 4% and 44% respectively (major 15% and minor 29% respectively). Five years actuarial survival rate was 16% (mean 34 +/- 5 months): this was significantly influenced by tumor's stage (stage I = 50%, stage IIa 30%, p<0,001) and nodal status (NO = 57%, N+ = 0%, p < 0,0001). Surgical approach was not significantly related with the incidence of post-operative complications and long term survival. Our results confirm that long term survival after surgical resection of oesophageal carcinoma remain poor (15-20%) and strictly related to tumor stages and lymph nodes involvement. Postoperative mortality/major complication rates are now acceptable.