Surgical treatment for carcinoma of the oesophagus in Chinese language publications

Abstract

This review is a meta-analysis of Chinese language publications on surgical treatment for oesophageal cancer. Between 1980 and 1994, 17,815 patients had surgery for carcinoma of the oesophagus. The male:female ratio was 3.9:1 and mean age was 51.9 (range 16-80) years. Mean resectability rate was 86.7 per cent and hospital mortality rate was 3.8 per cent. The crude 5-year and 10-year survival rates for all patients were 29.6 and 16.4 per cent respectively. For patients with stage 0 and stage I tumours, the 5-year survival rate was 95 and 89 per cent respectively, significantly greater than that for those with stage II, III and IV tumours (19.4 per cent, P < 0.01). The 5-year survival rate of all 2226 patients with tumour resection after radiotherapy was 38.0 per cent. There was no significant difference in survival following combination therapy compared with surgery alone. When compared with a report for the interval 1940-1979, there was no significant difference in the resectability, hospital mortality or 5-year survival rates. Oesophageal carcinoma remains a disease with dismal prognosis but surgery still offers the best chance of long-term survival. Adjuvant therapy has not yet proved an advantage in terms of survival but can be useful for palliation. Mass screening might improve survival but only in a population with a high incidence of oesophageal carcinoma.