Simultaneous Resection of Synchronous Esophageal and Gastric Cancers

Abstract

Background In patients with synchronous esophageal and gastric cancers, selecting an optimal conduit for esophageal reconstruction is a critical decision. The aim of this study was to evaluate the surgical outcomes after simultaneous resection of esophageal and gastric cancers according to the type of esophageal conduit used. Materials and Methods Clinicopathologic features and surgical outcomes were analyzed in 66 patients who underwent esophageal reconstruction with colon (n = 41, group C), jejunum (n = 11, group J), and stomach (n = 14, group S). Results Gastric cancer was adenocarcinoma and esophageal cancer was squamous cell carcinoma in every case. Inhospital mortality rate was 4.6% (n = 3). The complication rates were 6.1% for graft failure and 9.1% for anastomotic leakage. During the follow-up period (mean, 44.0 ± 49.6 months), 5-year overall and disease-free survivals were 50.6 and 48.1%, respectively. Especially, patient with stage I cancer for both esophageal and gastric lesion showed excellent survival outcome with 5-year overall survival rate of 82.0%. There were no significant differences in early mortality, incidence of graft complications or overall survival between the groups. The independent predictors of overall survival were the highest tumor stage (p = 0.008) and age (p = 0.009). Conclusion Simultaneous resection of gastric and esophageal cancers can be performed with reasonable early and late outcomes. The type of esophageal conduit used was not a determinant factor for early and late outcomes. © Georg Thieme Verlag KGStuttgart · New York.