Factors predictive of complete resection of operable XXXX : a prospective study.

@entity1 @entity2270 @entity418
BACKGROUND: Esophagectomy remains a standard treatment for @entity1 with resectable @entity418 , but the 5-year survival is only 20% to 25%. After complete resection survival is significantly longer than after incomplete resection with microscopic or macroscopic penetration. The purpose of this study was to prospectively identify the factors predictive of complete resection of operable @entity418 . METHODS: Betwen January 1995 and January 2002, 372 @entity1 with @entity418 underwent surgery with curative intent. Complete resection was performed in 304 @entity1 (81.7%), incomplete resection with microscopic penetration in 28 (7.5%), and incomplete resection with macroscopic penetration in 40 (10.8%). Univariate and multivariate analysis included 16 preoperative and operative factors. RESULTS: Factors predictive of complete resection were absence of any modification of the esophageal @entity2270 on the barium swallow (p = 0.019) and a partial or complete response to preoperative radiochemotherapy (p = 0.042). Three groups of @entity1 were identified: group 1 had no deviation of the @entity2270 on the barium swallow (n = 253); group 2 had deviation of the @entity2270 on the barium swallow and partial or complete response to radiochemotherapy (n = 66); and group 3 had deviation of the @entity2270 on the barium swallow and no response to radiochemotherapy or no preoperative treatment (n = 53). Rates of complete resection were 90.1%, 74.2%, and 50.9%, and 5-year actuarial survivals were 46%, 37%, and 0%, respectively (p < 0.001). CONCLUSIONS: Complete resection of @entity418 is predictable. Deviation @entity2270 on the barium swallow and morphologic response to neoadjuvant radiochemotherapy are variables available for all @entity1 at onset of therapeutic management.
