The surgical treatment of esophageal cancer in Sudan: A 100 consecutive cases

Abstract

Objective: Esophageal cancer is the most common gastrointestinal (GI) cancer in The Sudan. This study aimed to evaluate the outcome of the surgical management.

Methods: A 100 consecutive patients who underwent esophagectomy in Shaab Hospital in Khartoum during the period June 2003-Aug 2007 were studied.

Results: The mean age was 55 ± 14 years with an equal sex ratio. Fifty five per cent of patients presented with stage III&IV locally advanced and or metastatic disease. Sixty seven percent of the patients underwent a 2-stage resection, Lewis Tanner type while 27% underwent a 3-stage resection, McKeon operation and 6% had total gastrectomy with distal esophagectomy and roux-en-y reconstruction. The 30 days postoperative mortality was 10%. In 75 patients who could be traced, the overall 5 years survival was 21% (n = 16) and the 10 years survival was 8% (n = 6).

Conclusion: There was great improvement in the early postoperative mortality from 27% in 1986 to 10% in this series. The surgical treatment offered a rapid symptoms relief which suited most patients coming from distant locations and couldn't afford to stay for long in the Capital as will be required if chemo-radiotherapy was used as sole or as a neo-adjuvant treatment.

Keywords: Adjuvent; Cancer; Esophagectomy; Esophagus.