This prospective study highlights the improved survival following esophagectomy for early esophageal adenocarcinoma (50% survival at 5 years for node-positive patients) and the importance of surveillance with endoscopy and biopsy. In this group dysphagia predicted a poor prognosis, because this symptom meant the lesions were more advanced. The article also emphasizes the lower operative mortality rate (2 patients overall) that is possible in a dedicated surgical unit.
Improved survival of patients with adenocarcinoma of the cardia following resection for early lesions is reported from several centers.1-5 The overall 5-year survival rate following surgery reported from a European multicenter survey for intraepithelial, intramucosal, and submucosal tumors was 92.8%, 72.8%, and 44.3%, respectively.2 Recently Steup et al4 reported a 10-year survival rate of 72% following resection of tumors that did not have nodal metastases. These results are only possible when early diagnosis is made by surveillance with appropriate endoscopic,