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Ann Thorac Surg 1977;23:400-408
© 1977 The Society of Thoracic Surgeons

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Articles

Carcinoma of the Esophagus: Experience with a Philosophy for Palliation

Division of Thoracic and Cardiovascular Surgery, University of Maryland School of Medicine, Baltimore, MD.

^* Address reprint requests to Dr. Hankins, University of Maryland Hospital, Baltimore, MD 21201.

The preliminary results of a new therapeutic approach to carcinoma of the esophagus were reported in 1972. The primary objective of treatment should be palliation, with cure an important but secondary goal.

Lesions in the upper third of the esophagus are treated by irradiation unless there is severe obstruction or tracheal involvement, in which case colon bypass is carried out. Limited resection and esophagogastrostomy is performed through a right thoracotomy and midline laparotomy for middle-third lesions and through a left thoracotomy for lower-third carcinomas.

Since 1969, 85 patients have been evaluated, of whom 65 (76%) have been treated according to the new protocol. Thirteen patients with upper-third carcinomas were treated primarily by radiation therapy and 6 by colon bypass. Resection was performed in 45 of the 46 patients with middle- and lower-third lesions. There were 5 operative deaths (9.8%).

The quality and duration of palliation have been far superior to that achieved by previous methods of treatment and, perhaps surprisingly, survival rates have improved.

This article has been cited by other articles:

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