Esophageal Cancer. Approx. 13,000 cases/year in USA Post-esophagectomy overall 5 yr survival = 18% At presentation, 57% patients are Stage 3 , with a 10% post-esophagectomy surv. At presentation, 24% patients are Stage 2 , with a 35% post-esophagectomy surv.
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Visible tumor on endoscopic U/S
75% have tumor past mucosa into submucosa and beyond when seen on U/S
56% have lymph node metastases (both limited to and extending past submucosa)
Extended transhiatal esophagectomy
Complete lower mediastinal and upper abdominal lymph node resection
since only 19% had LNs if limited to submucosa
not “en bloc” since only 3% had > 4 LNsEsophagectomy -- Operation by Stage