Carcinoma of the Esophagus: A Disaster

Abstract

Because of the extremely high morbidity and mortality associated with esophageal carcinoma and our impression that squamous cell carcinoma of the esophagus was being seen with great frequency in young blacks, a retrospective study was undertaken at Charity Hospital of Louisiana and Touro Infirmary, both in New Orleans, from 1950 to 1965. Of the total of 548 patients studied, 9 survived five years, a rate of 1.6%. This extremely dismal picture was improved in patients who underwent palliative resection, among whom the five-year survival was 6%. Those in whom curative resection was attempted had a five-year survival of 15%. Attention should be paid to nutritional factors in the preoperative period. Preoperative radiation therapy should be considered, and it is suggested that many of these patients would do best with staged procedures involving total thoracic esophagectomy followed by retrosternal colon transplantation.