Medknow Publications on behalf of Indian Cancer Society
Abstract
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