[Strategy for the treatment of esophageal carcinoma]

Esophageal carcinoma is classified as one of the most malignant neoplasms owing to the difficulty of early detection, frequent lymph node metastasis, and high incidence of recurrence even after curative resection of the lesion. According to the increase of early cases of esophageal carcinoma with the progress of the diagnostic technique, endoscopic mucosal resection and blunt resection of the esophagus have come to be performed in cases with quite early carcinoma or poor risk factors. Hyperthermo-chemo-radiotherapy (HCR) is extremely effective for esophageal carcinoma, especially for the advanced cases. The 1-, 3- and 5-year survival rates of the cases treated with preoperative HCR and chemo-radiotherapy (CR) were 64.6, 35.0 and 23.9%, against 46.9, 20.0 and 3.4%, respectively. The prognosis of the cases treated with HCR was significantly better than that for cases treated with CR. Moreover, for far-advanced esophageal carcinoma cases, palliative therapy such as intubation should be performed to assure quality of life (QOL). Strict follow-up including postoperative combined therapies is required for an improved prognosis in esophageal carcinoma.