[Multidisciplinary treatment of cancer of the esophagus]

Multidisciplinary treatment is necessary for esophageal carcinoma. Radio-chemo-immunotherapy and aggressive chemotherapy with large doses of 5-FU, CDDP, ADR and VDS, were performed postoperatively from 1975. From 1975 to 1990, operations were performed on 456 patients with thoracic esophageal carcinomas. Postoperative radio-chemo-immunotherapy improved the 5-year survival rate of patients without lymph-node metastasis to 74.6% compared with 55.3% for patients not receiving any postoperative therapy. In the case of n1(+) and n2(+), the five-year survival rate of patients treated with aggressive chemotherapy (32.7%) was similar to the rate (34.8%) for patients treated with radio-chemo-immunotherapy. In cases of n3(+) and n4(+), improvement of the two-year survival rate of patients who received aggressive chemotherapy (37.0%) was noted compared with the rate of patients who received radio-chemo-immunotherapy (20.9%). However, there was no difference in five-year survival rate between the two groups. More effective multidisciplinary treatment based on randomized study will improve the therapeutic outcome.