The effectiveness of palliative resection for advanced esophageal carcinoma: analysis of 24 consecutive cases

Purpose: In some patients who already have advanced esophageal cancer at the time of presentation, symptoms like the inability to eat, and complications such as bronchoesophageal fistula are so debilitating that palliative resection may be beneficial. However, resection of the esophagus is associated with significant risk, and whether this operation should be performed for palliation remains controversial. Because few reports have been published on this subject, we retrospectively analyzed 24 patients with esophageal cancer who underwent palliative resection. Methods: Esophageal resection was performed with palliative intent in 12 patients and with curative intent in another 12 who were left with residual cancer. Results: There was no operative death. All of the ten patients who had been unable to eat preoperatively were able to eat after the operation, and four patients with a life-threatening bronchoesophageal fistula were free of symptoms after the operation. Two patients died in hospital during the postoperative chemotherapy but the other 22 were discharged. The mean survival period was 264 days. Conclusions: With improved postoperative care, the risk of palliative esophageal resection is no longer considered unacceptable. Received: July 2, 2001 / Accepted: March 5, 2002