This prospective study highlights the improved survival following esophagectomy for early esophageal adenocarcinoma (50% survival at 5 years for node-positive patients) and the importance of surveillance with endoscopy and biopsy. In this group dysphagia predicted a poor prognosis, because this symptom meant the lesions were more advanced. The article also emphasizes the lower operative mortality rate (2 patients overall) that is possible in a dedicated surgical unit.
Improved survival of patients with adenocarcinoma of the cardia following resection for early lesions is reported from several centers.1-5 The overall 5-year survival rate following surgery reported from a European multicenter survey for intraepithelial, intramucosal, and submucosal tumors was 92.8%, 72.8%, and 44.3%, respectively.2 Recently Steup et al4 reported a 10-year survival rate of 72% following resection of tumors that did not have nodal metastases. These results are only possible when early diagnosis is made by surveillance with appropriate endoscopic,
Bremner CG. Invited Commentary. Arch Surg. 1996;131(7):713. doi:10.1001/archsurg.1996.01430190035009