TY - CHAP M1 - Book, Section TI - Radical En Bloc Esophagectomy A1 - Altorki, Nasser K. A1 - Stiles, Brendon M. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - Despite improvements in perioperative care, surgical techniques, and neoadjuvant therapy over the past decade, the prognosis of esophageal cancer remains poor. More than 95% of new patients diagnosed annually in the United States succumb to disease. Among the subset of patients resected with curative intent (R0 resection), the 5-year survival after transthoracic esophagectomy or transhiatal esophagectomy rarely exceeds 30% based on reports from large surgical series.1–4 The principal justification for these poor results is the finding that most patients develop metastatic disease and already may have disseminated disease at the time of diagnosis. A careful analysis of the patterns of failure after surgical resection also implicates inadequate locoregional control. The locoregional failure rates are unacceptably high after conventional surgical resection, ranging from 30% to 60%.5–8 Although the addition of preoperative therapy may reduce rates of local failure and improve survival (Cross trial), a meaningful improvement in the survival of patients with esophageal cancer is unlikely without adequate surgical resection of the primary disease. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/14 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170406448 ER -