Esophageal cancer treatment Predicting and improving short- and long-term outcomes

Esophageal cancer is a very aggressive disease and is becoming more common, particularly in the Western world. Having lymph node metastasis is one of the most important factors predicting the prognosis of a patient with esophageal cancer. The lymphogenic metastasis pattern of patients with esophageal cancer is unknown and therefore the optimal radiotherapeutic and surgical treatment with regard to the lymph nodes is unknown. Studies included in the first part of this thesis focus on the lymphatic metastatic pattern of esophageal cancer and on which lymph nodes should be removed during surgery.
An operation for esophageal cancer is a very extensive operation, as more than half of the patients undergoing this operation develop one or more complications. Studies in the second part of this thesis focus on risk factors for complications, the optimal management of postoperative complications and the consequences of complications. Lastly, predictors for long-term survival after esophagectomy for cancer are also studied.