Original articleGeneral thoracicEsophagectomy for T1 Esophageal Cancer: Outcomes in 100 Patients and Implications for Endoscopic Therapy
Section snippets
Materials and Methods
We reviewed our experience retrospectively with 100 consecutive, pathologically proven T1 esophageal tumors treated with esophagectomy at the University of Pittsburgh Medical Center from 1995 to 2004. Patients who underwent neoadjuvant therapy or who had distant metastases were excluded. This study was approved by the University of Pittsburgh Institutional Review Board. Because this was a retrospective study, individual consent was waived.
Patient Characteristics
Esophagectomy was performed in 100 consecutive patients (79 men, 21 women) who were a median age of 68 years. The histology was adenocarcinoma in 91 (91%) and squamous cell carcinoma in 9 (9%). The tumor was intramucosal (T1a) in 29 patients and submucosal (T1b) in 71. The patient characteristics are summarized in Table 1. HGD was the preoperative diagnosis in 12 patients; of these, the final pathology specimen showed T1a (intramucosal) neoplasms in 4 patients, and submucosal lesions in 8
Comment
The incidence of esophageal cancer has increased dramatically during the past 3 decades [1]. Early-stage adenocarcinoma is more frequently encountered in clinical practice [2, 8]. In light of emerging endoscopic therapies for early-stage cancers, we have analyzed the results of surgical resection for T1 esophageal cancers in 100 consecutive patients. Our data show that esophagectomy is safe and effective. The perioperative mortality was low and demonstrates the safety of primary surgery for
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