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Ann Thorac Surg 1975;19:688-697
© 1975 The Society of Thoracic Surgeons

Articles

Esophageal Carcinoma

The Value of Staging in Long-Term Survival

Jorge O. Just-Viera, M.D.*, Jose E. Silva, M.D.

From the Section of Thoracic and Cardiovascular Surgery, San Juan City Hospital, San Juan, Puerto Rico.

* Address reprint requests to Dr. Just-Viera, Department of Surgery, San Juan City Hospital, San Juan, Puerto Rico.

A three-stage study of 177 patients in Puerto Rico who had esophageal carcinoma is presented. Those surviving five or more years over a twenty-one-year period were located. Next, the experience at the San Juan City Hospital from 1968 to 1973 was examined. The information obtained from those two groups led to the last stage, a prospective study in which treatment was based on objective staging of the extent of the disease. Only 27% of these patients are really potentially curable upon admission to the hospital, and they should have aggressive therapy. Adequate palliation can be obtained with radiotherapy and chemotherapy in the remainder. The findings that nearly half of the five-year survivors had metastases or tumor extension and that some patients survived for prolonged periods without treatment emphasize the need for individualized treatment and research in tumor immunology.




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