Autopsy findings in patients after curative esophagectomy for esophageal carcinoma

Journal of the American College of Surgeons
Atom KatayamaMichio Kaminishi

Abstract

The mode of recurrence after esophagectomy for esophageal cancer has seldom been studied in detail from autopsy findings. We reviewed the autopsy findings in 43 curatively resected cases of esophageal cancer between 1976 and 1997 at a single institution. Recurrent or residual esophageal cancer was identified in 27 of the 43 patients (62.8%) at autopsy. Local recurrence, lymph node metastases, hematogenous metastases, and serosal carcinomatosis were observed in 11 (25.6%), 18 (41.9%), 17 (39.5%), and 11 patients (25.6%), respectively. Metastases to the thoracic, abdominal, and cervical nodes were observed in 37.2%, 16.3%, and 11.6% of the cases at autopsy, respectively. The pulmonary hilar nodes were most frequently involved (25.6%). The frequency of local recurrence was significantly lower in cases after curative subtotal esophagectomy with two- or three-field dissection (19.4%) than in cases after lower esophagectomy (66.7%) (p = 0.032). The frequency of hematogenous metastases after curative esophagectomy after preoperative radiotherapy was significantly lower in responders (Grades 2 to 3) than in nonresponders (Grades 0 to 1) (p = 0.035). This study showed the characteristics of recurrence after esophagectomy for esophageal ...Continue Reading

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