Survival following Surgical Treatment for Esophageal Cancer with Liver Metastases

Abstract

An analysis of prospectively collected data was made on 490 patients with carcinoma of the esophagus seen between July 1982 and December 1986 to determine the incidence of synchronous liver metastases and the outcome of these patients. Twenty-seven patients (5.5%) had liver metastases detected by clinical examination, ultrasound scanning or at laparotomy. Fourteen patients had palliative resection of the tumor, 2 had a bypass, 7 had a laparotomy only and 4 were moribund. The median survival of resected patients was 4.5 months (range: 2–42 months) and for those with exploration alone it was 2.0 months (range: 0.5–7 months). The 2 patients who had a bypass lived 6 and 7 months, respectively. Patients undergoing exploration only had, in addition to liver metastases, unresectable primary tumors with peritoneal seedlings which precluded even a bypass. No statistically significant difference in survival can be demonstrated between this group of patients with liver metastases and those without liver involvement undergoing similar palliative treatment. We conclude that when relief of dysphagia is the primary goal of treatment, liver metastasis per se should not deter attempts at performing the most effective palliative procedure possible.