Management of Oesophageal Carcinoma:A Report of 267 Cases

Abstract

A series of 267 patients with oesophageal carcinoma is presented. There were 151 women and 116 men; the mean age was 65 years. During the whole period 1960–1971 surgical excision was the treatment of choice. The overall operability was 45.2% and the re-sectability of the whole material 30.3%, but 66.9% of the cases were considered operable. Eighty-one patients were treated by surgical excision and anastomosis. The method of choice was one-stage oesophagectomy and oesophagogastrostomy. Altogether 87 patients received irradiation therapy alone. This group consisted of patients who were found inoperable at exploration or estimated to be unsuitable for radical surgery. In the group of 99 patients without active therapy, feeding gastrostomy or a Celestin tube was used in 43 cases.Early mortality rate after oesophageal resection was 18.5%; 13% during the last 6-year period. During this period one-third of the patients were more than 70 years of age. Anastomotic leakage was verified in five cases (6.2%), three of these died. Pulmonary embolism was the most usual cause of death. After radiotherapy, pulmonary fibrosis, strictures and fistulas occurred in 32%. The 5-year survival rate after excisional surgery was 22% and the 3-year survival 38%. After radiotherapy, the 3-year survival rate was 4% and 2-year survival 10%. After complete cobalt therapy, the 2-year survival rate was 15%. The mean survival time after roentgen therapy was 9.1 months, after cobalt therapy 11.1 and after photon therapy 10.6 months. The mean survival time of the untreated cases was 4.0 months. The overall 5-year survival for the total series was 7.8%.