Surgery of localized cardioesophageal cancer.

In cardioesophageal cancer the 5-year survival was 52.5% for operations on patients without regional metastasis or involvement of the serous gastric membrane. When regional metastases were present, the 5-year-survival was 23.3%. When the whole wall was invaded with the tumor but there were no metastases to the regional lymph nodes, the 5-year survival increased to 38.2%. In cases involving both invasion and metastases, the percentage of 5-year survivors was 13.3%. These findings indicate the prognostic significance of metastatic spread to regional lymph nodes. When cardioesophageal tumor invasion spreads beyond the original tumor site, combined resection yields apparently similar results. The experience of this clinic permits us to conclude that potential progress in obtaining improved long-term results for esophageal cancer management is dependent on advances in lymph node dissection methods and the search for effective combinations of systemic treatment, involving chemotherapy or immunotherapy.