RT Book, Section
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
SR Print(0)
ID 1170406448
T1 Radical En Bloc Esophagectomy
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170406448
RD 2024/04/25
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.