EVOLUTION OF ONCOLOGIC TREATMENT OF ESOPHAGEAL CANCER: INCREASE IN OVERALL SURVIVAL IN 335 CASES OPERATED OVER 20 YEARS IN A SINGLE INSTITUTION

Summary Objective: To present the surgical and oncological results of patients with esophageal cancer who underwent surgery in the same institution at three different historical moments, and to compare their outcomes according to the treatment strategy used. Method: Comparative analysis of the surgical results obtained by the Oncological Surgery Service of Hospital Erasto Gaertner, in the treatment of esophageal cancer, in three different chronological moments. The procedure was always performed by the same team in the three moments. The 3 analyses were divided as follows: It was 1 (1997), It was 2 (2003), It was 3 (2015). The data were analyzed with the programs SPSS 23.0 and STATA15, being p<0.05 considered statistically significant. Results: 335 patients underwent esophagogastricrectomy during the study period. Neoadjuvance was significantly higher in Era 3, where it reached 55.4% of patients. We observed a histological change in the diagnosis over time, with a significant increase in adenocarcinoma. The surgical variables did not show statistical differences in the 3 historical moments. Morbidity and mortality rates were higher in Era 3. The main complications were pulmonary and anastomotic fistulas. The overall survival in 5 years was increasing over time, reaching 59.7% in Era 3. Conclusions: The evolutionary study of the cases demonstrates the continuous improvement of the results of the service in the treatment of esophageal cancer. Better preoperative nutritional therapy associated with neoadjuvant treatment increased the overall survival of patients.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019