CA: A Cancer Journal for Clinicians, Vol 33, 264-281, Copyright
© 1983 by American Cancer Society
Carcinoma of the Esophagus
F. Henry Ellis Jr. M.D., Ph.D.1
1 Clinical Professor of Surgery at Harvard Medical School and Chief of the Sections of Thoracic and Cardiovascular Surgery at Lahey Clinic Medical Center in Burlington, Massachusetts, and The New England Deaconess Hospital in Boston, Massachusetts.
While controversy will continue about the proper therapy for the palliation of symptomatic patients with carcinoma of the esophagus or cardia, my preference is for primary resection and restoration of alimentary continuity by esophagogastrectomy. It can be applied to most patients with this disease and can be carried out with low mortality and morbidity. The period of treatment is short compared with other forms of therapy, particularly those employing the combination of several modalities. It allows the patient to return home relatively quickly. Furthermore, palliation is provided to more than 90 percent of patients, which is better than that reported after other forms of therapy.
While cure rates remain low after any form of therapy for carcinoma of the esophagus, the longevity after resection exceeds that after other forms of therapy. Until properly randomized controlled studies demonstrate the superiority of combined forms of therapy, the added time required for their implementation and accompanying morbidity do not justify their widespread use.
By far the best results of treatment are those reported from areas in China where the disease is widespread and routine screening techniques are employed. Early detection, therefore, seems to be the clue to long-term survival after resection.
