PMID: 6159066Oct 15, 1980Paper

Esophageal and gastroesophageal junction carcinoma: an evolved philosophy of management

Cancer
H A Heck, N P Rossi

Abstract

One hundred eleven patients with esophageal and gastroesophageal junction carcinoma were treated in the last 12 years. Fifty-seven (52%) underwent resection for cure (38%) or for palliation (14%). Overall operative mortality was 32% (18/57), being greatest with colon interposition (71%) or gastric tube (67%) and least with esophagogastrectomy (11%). Major complications--anastomotic leak being the most important--were strikingly more prevalent (71 and 66%) with the first two procedures than with esophgoastrectomy (14%). The mean survival time in patients resected for cure was 17 months compared to seven in those treated primarily by radiation. In addition, radiation therapy was accompanied by a 20% major complication rate and by less subjective palliation. In the surgically-resected group, there was a two, three, and five year survival of 26, 9, and 5%. Incomplete removal of tumor did not improve survival above that attained with untreated patients. Morbidity and mortality associated with use of endoprostheses in an additional 27 patients was 65%. This experience has led us to espouse the following approach: 1) The main thrust of treatment should be to resect gross tumor completely. 2) The use of the stomach in reconstruction at...Continue Reading

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Citations

Nov 1, 1992·Journal of Clinical Ultrasound : JCU·F EftekhariT G Mahon
Oct 1, 1987·Baillière's Clinical Gastroenterology·J W Reeders, T L Tio
Jan 13, 2000·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·C C SchirmerL Brentano
May 1, 1987·Annals of Surgery·J L Mahoney, R E Condon
Jan 1, 1983·Langenbecks Archiv für Chirurgie·U PralatH G Borst

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