A study of patients having survived curative operation for esophageal cancer for five years or more.

ABSTRACT

In order to analyze the prognostic factors for curatively resected esophageal cancer, 42 patients who had survived their operation more than 5 years (long-term survivors) were compared for clinicopathologic items with 30 recurrent patients who had died within 5 years postoperatively (recurrent cases). Moreover, to estimate the prognosis for the current survivors, we investigated the cause of death of long-term survivors who had died. This comparison showed that the rate of lymphatic invasion was 36.4% and of blood vessel invasion 19.4% for the survivors, much lower than those of the recurrent cases which were respectively 62.1% and 31.0%. It was found that the significantly unfavorable prognosis-determinant factors was lymphatic invasion (p < 0.05). Ten out of 12 n (+) survivors (83.3%) had single metastasing region, one in the neck, three in the mediastinum and six in the abdomen. This was not significantly different from the recurrent cases, of whom, ten out of 14 n (+) cases had a single metastasing region, six in in the mediastinum and four in the abdomen. As for the number of metastatic lymph nodes, nine out of 12 n (+) survivors (75%) had only one matastatic lymph node, and none of them had more than three. On the other hand, two of the recurrent cases had more than three. Of the 42 long-term survivors, 21 patients are still alive (current survivors' average age 70.1 +/- 7.9) and 21 have died. The cause of death was recurrence in six cases, metachronous primary malignant tumor in three, other disease in six and unknown in six. The average age of death was 62.1 +/- 10.3 in cases of recurrence or double cancer, and 71.8 +/- 9.5 in others. The former were thus significantly younger than the latter (p < 0.05).