Esophageal Cancer

Stanford is the highest volume and highest quality esophagectomy center in the San Francisco Bay Area. Stanford thoracic surgeons have performed forty to sixty esophagectomies per year for each of the past several years. We consider excellence in the surgical management of esophageal cancer, along with management of lung cancer, to be at the core of the mission of the Thoracic Surgery service at Stanford.

Each year, approximately 17,000 new cases of esophageal cancer are diagnosed. By the time most patients notice symptoms, the disease is locally advanced. Patients with localized disease have a 5-year survival rate of about 35%; fortunately, cure rates are substantially higher than this for stage I and early stage II tumors. In recent years, there has been a trend towards increased incidence of adenocarcinoma (one of the subtypes of esophageal cancer), arising at the gastroesophageal junction (where the stomach meets the esophagus). This is now the most common type of esophageal cancer in the United States. It tends to develop in those who have the changes of  "Barrett's esophagus" in their lower esophagus, resulting from chronic reflux of stomach acid into the lower esophagus.  

Of all operations in which the association between surgical volume and outcomes (surgical results) has been studied, esophagectomy (removal of all or part of the esophagus) is the operation for which the data is clearest that the procedures should be performed at high volume medical centers with the greatest expertise and skills, such as at Stanford Health Care.

Figure 1. Laparoscopic incisions for Minimally Invasive Ivor Lewis Esophagectomy

Figure 4. The right VATS incisions that are used to mobilize the esophagus.

Figure 7. Completion of the Esophago-Gastric Anastomosis.

Figure 2. Division of the Gastro-Colic Ligament during laparoscopic mobilization of the stomach

Figure 5. Thoracoscopic (VATS) mobilization of the esophagus.

Figure 8. Completed Minimally Invasive Ivor Lewis Esophagectomy.

Figure 3. Laparoscopic preparation of the gastric conduit (Neo-esophagus).

Figure 6. Esophago-Gastric anastomosis with a circular stapler.

If you would like to make an appointment to see one of our surgeons for any of these problems, please call (650) 498-6000 and ask for the Thoracic Surgery new patient coordinator, or call (650) 721-2086.

The Division of Thoracic Surgery in the Department of Cardiothoracic Surgery at the Stanford School of Medicine is located in the San Francisco Bay Area in northern California. For more information about our services, please contact Donna Yoshida at (650) 721-2086 or Cliff David at (650) 721-6400. For new patient Thoracic Surgery Clinic Scheduling, please call (650) 498-6000.