Survival with Carcinoma of the Esophagus

Abstract

From January 1958 to December 1969, 415 white and 185 nonwhite patients with the histologic diagnosis of squamous cell carcinoma of the esophagus were seen. They received various modalities of treatment such as resectional surgery, orthovoltage radiotherapy, cobalt-60 teletherapy, resectional surgery followed by radiotherapy, resectional surgery followed by radiotherapy and chemotherapy, radiotherapy plus chemotherapy, chemotherapy alone, or palliative therapy that consisted of esophageal dilation by bougienage, permanent intubation with an indwelling cannula, or cervical esophagostomy and gastrostomy with external shunt. Statistically, no single treatment modality or combination of modalities offered any clear-cut advantage in enhancing the survival rate. Only four patients who had resectional surgery and one patient who had cobalt-60 teletherapy survived 5 years. Resectional surgery relieved the dysphagia symptoms immediately, but the surgical mortality was high. Supervoltage irradiation presented problems such as further esophageal stricture, fistula, and pulmonary fibrosis.