Clinical characteristics and survival of esophageal cancer patients: annual report of the surgical treatment at Shanghai Chest Hospital, 2018.

BACKGROUND: Esophageal cancer remains a major health burden in China, and surgical resection is the cornerstone of curative treatment. Continuous annual reports from high-volume centers provide valuable benchmarks for evaluating temporal changes in surgical practice and outcomes. This report summarizes the clinical characteristics, perioperative outcomes and survival of patients who underwent surgical or endoscopic treatment for esophageal cancer at Shanghai Chest Hospital (SCH) in 2018. METHODS: We retrospectively analyzed patients treated in 2018 based on data from the prospectively maintained SCH esophageal cancer database. Baseline demographics, treatment modality, pathological findings, postoperative complications, and survival outcomes were collected. The 2016 and 2017 SCH cohorts were included for descriptive temporal comparison. RESULTS: A total of 714 patients underwent surgical treatment in 2018, including 654 esophagectomies and 60 endoscopic resections. Among the esophagectomy cohort, squamous cell carcinoma predominated (87.0%), and pathological T3 tumors accounted for 42.0%. Pathological nodal involvement was present in 51.7% of patients, with a median of 19 lymph nodes examined. Perioperative multidisciplinary treatment was conducted in 368 esophagectomy patients and four endoscopic submucosal dissection patients. In the esophagectomy cohort, minimally invasive approaches accounted for 80.6% of procedures. Postoperative complications after esophagectomy occurred in 33.9% of patients, with major complications (Clavien-Dindo ≥ III) in 11.5%; pleural effusion (11.0%) and recurrent laryngeal nerve injury (10.9%) were the most frequent specific complications. Thirty-day and 90-day mortality were low (0.7% and 1.8%, respectively). Five-year overall survival and cancer-specific survival were 53.8% and 59.9%, respectively. CONCLUSIONS: The 2018 SCH experience demonstrated a transition toward minimally invasive techniques and centralized care without compromising oncologic adequacy or short-term safety. Compared with 2016-2017, 2018 presented a modest shift toward superficial primary tumor invasion, a stable nodal burden, and a complication profile that may reflect evolving procedure mix and case selection. Continued prospective quality monitoring and data-driven refinement of perioperative management are warranted to further optimize outcomes.