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 ORIGINAL ARTICLE
Year : 2011  |  Volume : 48  |  Issue : 1  |  Page : 34-39

Eight-year experience in esophageal cancer surgery


1 Department of Surgical Oncology, BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal
2 Xingtai City Cancer Hospital, China
3 Ist Hebei Cancer Hospital, China

Correspondence Address:
B Thakur
Department of Surgical Oncology, BP Koirala Memorial Cancer Hospital, Bharatpur
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.75821

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Aim: Esophageal cancer remains a major and lethal health problem. In Nepal, not much has been explored about its management. The aim of this study was to conduct a retrospective review of esophageal cancer patients undergoing surgery or combined modality treatment at a cancer hospital in Nepal. Materials and Methods: Resectable cases were treated primarily with surgery. Locally advanced cases with doubtful or obviously unresectability underwent preoperative chemo/radiation or chemoradiation followed by surgery. Results: Among 900 patients, 103 were treated with curative intent. Mean age of patients was 54 years, and 100% of the patients presented with complaint of dysphagia. Surgery as a single modality of treatment was done in 57% of cases, and the remaining underwent combined modality treatment. Transthoracic and transhiatal approaches were used in 95% and 5% of cases, respectively. Nodal sampling, two-field (2-FD), and three-field lymphadenectomy (3-FD) were done in 18%, 59%, and 20% of cases, respectively. A majority of patients had pathological stage III disease (46.6%). In-hospitality mortality was 5%, and anastomotic leakage rate was 14%. In 87% of patients, R0 resection was achieved. Overall, 4-year survival was 20%. A R0 resection, early-stage disease and 3-FD favored the survival advantage (P < 0.05). Conclusion: The mortality, complication, and survival results were in the acceptable range. R0 resection and radical nodal dissection should be standard practice.






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