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Marc R. Moon, MD; William J. Schulte, MD; George B. Haasler, MD; Robert E. Condon, MD

Arch Surg. 1992;127(8):951-955.

Abstract
• Adenocarcinoma of the esophagus is no longer rare and is treated by resection. To determine whether the approach used for resection influences outcome, we studied 88 patients who underwent resection; 14 had stage I or II disease, 74 had stage III, and 40 had stage IV. One third of those with Barrett's esophagus were noted on screening endoscopy to have potentially curable disease; the others were diagnosed with stage III or IV disease. Transhiatal esophagectomy was performed in 63 patients; 24 patients underwent transthoracic esophagectomy. We found no difference in survival or morbidity between transhiatal and transthoracic esophagectomy. Overall 5-year survival for stage I and II disease was 86%. For stage III and IV disease, 5-year survival was 14.5%. Aggressive surveillance of Barrett's esophagus facilitates the discovery of early disease. Esophagectomy for adenocarcinoma can result in cure of early cancers and improved palliation of more advanced disease.

(Arch Surg. 1992;127:951-955)

Author Affiliations
From the Department of Surgery, Medical College of Wisconsin, Milwaukee.

Footnotes
Accepted for publication March 7, 1992.

Presented at the 99th Scientific Session of the Western Surgical Association, Colorado Springs, Colo, November 19, 1991.

Reprint requests to Department of Surgery, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226 (Dr Schulte).

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