Esophagectomy, why? Or why not?

Esophagectomy... why? Or why not?
From a fellow counselor on our twice-weekly EC Zoom calls. He knows a bit, and assembled this from ChatGpt.

As a 16-year esophageal cancer survivor, I have participated in various esophageal cancer forums for the past 15 years. The most frequently asked question is, “Do I really have to proceed with an esophagectomy?” Could I achieve a similar outcome with chemoradiation therapy and/or immunotherapy? Additionally, concerns about the quality of life after surgery arise.

The answer to the first question is that current statistics indicate a significantly increased long-term survival rate with surgical removal of the tumor and adjacent lymph nodes.

The answer to the second question is that with some minor lifestyle adjustments, quality of life is quite good after a one or two-year period of adjustment and recovery from surgery.

To illustrate the significant difference, I have prepared a chart that compares survival outcomes for surgery versus no surgery, differentiated by esophageal cancer type (as there are variations in treatment results for adenocarcinoma and squamous cell cancer).
Please refer to the chart below.

It is important to note that this chart does not account for patient age and the number of comorbidities. The outcomes for a 78-year-old patient with COPD or cardiac issues compared to a 55-year-old in good general health will differ. Most surgeons will evaluate a patient’s eligibility or disqualification based on age and comorbidities.

While an esophagectomy is not an ideal procedure, most of us who have had surgery are glad we took all necessary steps to ensure long-term remission. As with all aspects of life, we can adapt to the lifestyle changes required after surgery.