PROGNOSTIC MARKERS IN PATIENTS WITH CARCINOMA OF THE ESOPHAGUS

Of the vast number of potential prognostic factors, only an R(o) resec tion, that is complete macroscopic and microscopic tumour removal, and the nodal status are undisputed independent predictors of survival in patients with localized oesophageal carcinoma. The prognostic impact of the DNA distribution pattern and a variety of oncogenes and tumour suppressor genes remains to be proven in prospective studies with suff iciently large patient populations. Combined modality therapy appears to improve survival only in those patients who respond to neo-adjuvant treatment and have a subsequent R(o) resection. Consequently, only pa tients in whom complete macroscopic and microscopic tumour removal is indicated, based on preoperative assessment, should undergo primary re section for oesophageal carcinoma. Extended lymphadenectomy may improv e survival in patients with a limited number of involved mediastinal l ymph nodes.