• Noel E Donlon, Narayanasamy Ravi, Sinead King, Moya Cunninhgam, Sinead Cuffe, Maeve Lowery, Carmel Wall, Niall Hughes, Cian Muldoon, Ciara Ryan, Jenny Moore, Catherine O'Farrell, Claire Gorry, Ann-Marie Duff, Cathy Enright, Tim S Nugent, Jessie A Elliot, Claire L Donohoe, and John V Reynolds.
• National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland. donlonn@tcd.ie.
• Ir J Med Sci. 2021 Feb 1; 190 (1): 297-305.

BackgroundOesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center.MethodsAll patients undergoing surgery or multimodal therapy with curative intent from 2009 to 2018 were studied. All data was recorded prospectively and maintained internally. The period 2009-2013 was compared with 2014-2018 to monitor any change in trends.ResultsFour hundred and seventy-five patients (adenocarcinoma 77%, mean age 65; 76% male; 64% neoadjuvant therapy) underwent open surgical resection, 54% via en bloc 2-stage, 19.8% en bloc 3-stage, and 26.5% by a transhiatal approach. New onset atrial fibrillation was the commonest index complication, in 108 (22.7%), 80 (18%) developed suspected pneumonia/respiratory tract infection, 20 (4.2%) an anastomotic leak, and 25 (5.2%) a chyle leak. The 90-day mortality rate was 1.2% and 0.8% at 30 days. The median survival was 77.17 months, with a 5-year survival of 56%.ConclusionConsistent with registry data on population survival for oesophageal cancer, this study highlights markedly improved survival outcomes in patients treated curatively, reflecting international trends, as well as low mortality rates; however, cardiorespiratory complications remain significant.

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