Analysis of factors influencing long-term survival after surgical resection for oesophageal squamous cell carcinoma

Objective : We evaluated prognostic factors in 34 patients discharged from hospital after surgical resection for oesophageal squamous cell carcinoma. Material and Methods: There were 22 males and 12 females; mean age was 59.3 years (range 42-77 years). Preoperative neoadjuvant treatment consisted in chemotherapy alone in three patients and in combined radiochemotherapy in 14. Digestive continuity was restored with a gastric transplant in 26 patie nts and a colonic graft in 8. Surgery was curative in 28 patients and palli ative in 6. There were three stage I, 14 stage II, 13 stage III, and 4 stag e IV diseases. In 19 patients the lymph nodes were invaded. The tumour was well differentiated in 17 patients, moderately in 9, and poorly in 8. Results: Follow-up ranged from 2 to 100 months. Overall median postoperativ e survival was 21 months. By univariate analysis, factors influencing survi val were curative surgery (p = 0.04), stage (p = 0.006), and nodal involvem ent (p = 0.0003). Nodal involvement was an independent prognostic factor by multivariate analysis (p = 0.0002). Patient age and sex, perioperative tra nsfusion, digestive transplant, tumour local extension, grade of differenti ation, and distant metastasis did not influence survival. Also, we did not observe any significant benefit of preoperative or postoperative chemothera py or radiochemotherapy. Conclusions: Nodal involvement was the most important prognostic factor inf luencing survival. Therefore, an earlier diagnosis of oesophageal cancer in a less advanced stage is important to improve survival rates. Our study co uld not confirm the benefit of neoadjuvant therapy in terms of late surviva l.