LAUSR

Many things have changed in treatment for patients who underwent esophagectomy for cancer in the last decades, such as neoadjuvant chemoradiotherapy and minimally invasive esophagectomy. This study was performed to evaluate developments in survival after esophagectomy for cancer over the last 25 years. Patients who underwent esophagectomy for esophageal or gastroesophageal junction (GEJ) carcinoma between January 1993 and February 2017 were selected from a prospectively maintained database of a tertiary referral center, guaranteeing minimum follow-up of 12 months at time of the analyses. Patients were divided in different groups according to year of esophagectomy: A) 1993–1997, B) 1998–2002, C) 2003–2007, D) 2008–2012, and E) 2013–2017. Follow-up was truncated at a maximum of 60 months. Survival outcomes were assessed by Kaplan Meier estimate, using log-rank tests to compare survival curves between groups. A total of 1503 patients were included. Median follow-up was 55.8 months (IQR 31.5–60.0). Median estimated overall survival for all patients was 36.4 months (95% CI 31.8–40.9) and improved from 26.1 months (95% CI 19.3–32.8, period A) to 46.1 months (95% CI 36.9–55.3) in period E (P = 0.001). Cumulative 1- and 3-years survival increased from 69.3% and 42.4% (period A) to 79.2% and 54.6% (period E, P < 0.05) respectively. The cumulative 5-years survival improved from 30.5% (period A) to 43.4% in period D (P = 0.007). Survival after esophagectomy for cancer improved significantly in the last 25 years. Additional investigations should be performed to assess predictive factors for survival, in order to further improve survival. All authors have declared no conflicts of interest.