An outcome comparison of adenocarcinoma of the esophagus to squamous cell carcinoma after transthoracic esophagectomy

Background: In this study, we assessed the results of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) cases of distal esophagus, who underwent transthoracic esophagectomy. Methods: Between January 1999 and July 2010, 22 ADC (12 females, 10 males; mean age 61.5 +/- 11.2 years; range 40 to 79 years) and 48 SCC cases of distal esophagus (28 females, 20 males; mean age 56.8 +/- 12.1 years; range 28 to 83 years), who underwent transthoracic esophagectomy were retrospectively analyzed. Results: The most commonly encountered symptoms of ADC and SCC were dysphagia and weight loss (90.9%, 40.9% and 93.8%, 37.5%, respectively). Six cases (27.3%) with ADC and 18 cases with SCC (37.5%) had smoking history. Four cases with ADC (18.2%) and 21 cases with SCC (43.8%) developed postoperative complications (p=0.033). No intraoperative mortality is observed in ADC cases, while three SCC cases (6.3%) died intraoperatively. Median survival was 34.3 months in ADC and 30.5 months in SCC. Five-year survival was 33.3% in ADC and 17.1% in SCC cases (p=0.55). Conclusion: In this study, it was observed that postoperative complication rate was significantly higher in SCC compared to patients with ADC; however, there was no statistically significant difference in the long-term survival. Transthoracic esophagectomy appears to be a safe treatment modality in distally located esophagus cancer cases.