[Advantages and limits on the surgical therapy of esophageal cancer]

During a 11-year period, 315 patients of squamous cell carcinoma of the thoracic esophagus were treated. Notwithstanding the great majority of the patients had advanced cancer and operative contra-indications were very limited, the percentage of the operation of total patients was 94% (297/315) and that of operative mortality was 7.0% (20/297). As a standard surgical procedure, subtotal esophagectomies were performed through a right thoracotomy, followed by a laparotomy with simultaneous reconstruction via the posterior mediastinal route. On the 181 cases of the squamous cell carcinoma of the thoracic esophagus resected and reconstructed by this method before 1977, the survival rate of 1-year was 50%, that of 3-years was 19% and that of 5-years was 10%. Post operative T-shaped irradiation was performed in about a half of the total 181 patients. The efficacy of the postoperative irradiation was discernible in patients of each stage. It is expected that a precise schedule of chemotherapy and immunotherapy combined with post-operative irradiation might improve the prognosis of the esophageal cancer.