Early oesophageal cancer: Results of a European multicentre survey

Abstract

Early oesophageal cancer has been extensively studied in Far-Eastern countries, where its prevalence is high. A multicentre survey was conducted within the Groupe Européen pour l'Etude des Maladies de l'Oesophage to analyse results of surgical treatment in patients with disease staged as pTis-T1 N0 M0 according to the tumour node metastasis classification. Of 9743 patients with squamous cell oesophageal carcinoma observed since 1980, 4663 underwent resection; 253 (5·4 per cent) of these fulfilled the criteria for inclusion in the study. The overall mortality rate was 9·1 percent (23 patients), and was higher after transthoracic than transhiatal oesophagectomy (10·7 versus 6 per cent, P not significant). Pathological examination showed an intraepithelial tumour in 46 patients (18·2 percent), intramucosal carcinoma in 64 (25·3 percent) and a submucosal lesion in 143 (56·5 percent). The overall 5-year survival rate for patients with intraepithelial, intramucosal and submucosal tumours was 92·8, 72·8 and 44·3 percent respectively. The 5-year survival rate was higher after transthoracic than transhiatal oesophagectomy (66 versus 52 percent). No survival advantage was observed after either operation in patients with mucosal tumours. Of 21 patients with recurrent disease, 20 had a submucosal lesion. The 5-year survival rate in patients with submucosal tumour was higher after transthoracic than transhiatal oesophagectomy (54·2 versus 25·5 per cent).