Ömer YILMAZ, Atila EROĞLU, Ali Bilal ULAŞ, Yener AYDIN

An outcome comparison of adenocarcinoma of the esophagus to squamous cell carcinoma after transthoracic esophagectomy

Amaç: Bu çalışmada transtorasik özofajektomi uygulanan distal özofagus yerleşimli adenokarsinom (ADK) ve skuamöz hücreli karsinomlu (SHK) olguların sonuçları değerlendirildi. Çalışma planı: Ocak 1999 ve Temmuz 2010 tarihleri arasında transtorasik özofajektomi uygulanan distal özofagus yerleşimli 22 ADK (12 kadın, 10 erkek; ort. yaş 61.5±11.2 yıl; dağılım 40-79 yıl) ve 48 SHK olgusu (28 kadın, 20 erkek; ort. yaş 56.8±12.1 yıl; dağılım 28-83 yıl) retrospektif olarak incelendi.Bulgular: Adenokarsinom ve SHK’de en sık görülen semptomlar disfaji ve kilo kaybı (sırasıyla %90.9, %40.9 ve %93.8, 37.5%) idi. Adenokarsinomlu altı olguda (%27.3), SHK’li 18 olguda (%37.5) sigara içme öyküsü vardı. Ameliyat sonrası komplikasyon ADK’li dört olguda (%18.2) ve SHK’li 21 olguda (%43.8) gelişti (p=0.033). Ameliyat sırası ölüm ADK’li olgularda gözlenmez iken, SHK’li üç olgu (%6.3) ameliyat sırasında hayatını kaybetti. Medyan sağkalım ADK’de 34.3 ay, SHK’de 30.5 ay idi. Beş yıllık sağkalım ADK’de %33.3, SHK’de %17.1 idi (p=0.55).Sonuç: Bu çalışmada ameliyat sonrası komplikasyon oranının SHK’de ADK’lı olgulara göre anlamlı derecede daha yüksek olduğu, ancak uzun dönem sağkalımda istatistiksel olarak anlamlı bir fark olmadığı görüldü. Distalde yerleşmiş özofagus kanserli olgularda transtorasik özofajektomi güvenli bir tedavi yöntemi olarak görülmektedir.

Adenokarsinom ve skuamöz hücreli karsinomlu distal özofagus kanserinde transtorasik özofajektomi sonuçlarının karşılaştırılması

Background: In this study, we assessed the results of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) cases of distal esophagus, who underwent transthoracic esophagectomy. Methods: Between January 1999 and July 2010, 22 ADC (12 females, 10 males; mean age 61.5±11.2 years; range 40 to 79 years) and 48 SCC cases of distal esophagus (28 females, 20 males; mean age 56.8±12.1 years; range 28 to 83 years), who underwent transthoracic esophagectomy were retrospectively analyzed.Results: The most commonly encountered symptoms of ADC and SCC were dysphagia and weight loss (90.9%, 40.9% and 93.8%, 37.5%, respectively). Six cases (27.3%) with ADC and 18 cases with SCC (37.5%) had smoking history. Four cases with ADC (18.2%) and 21 cases with SCC (43.8%) developed postoperative complications (p=0.033). No intraoperative mortality is observed in ADC cases, while three SCC cases (6.3%) died intraoperatively. Median survival was 34.3 months in ADC and 30.5 months in SCC. Five-year survival was 33.3% in ADC and 17.1% in SCC cases (p=0.55).Conclusion: In this study, it was observed that postoperative complication rate was significantly higher in SCC compared to patients with ADC; however, there was no statistically significant difference in the long-term survival. Transthoracic esophagectomy appears to be a safe treatment modality in distally located esophagus cancer cases.

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