End results of the surgical treatment of carcinoma of the esophagus

ABSTRACT

Three hundred and twelve cases with carcinoma of the esophagus were treated at NCI, Cairo University, in the period 1980-1985, 234 males and 78 females with a male female ratio of 31, their age ranged between 20 to 84 years with a mean age of 53.7 years. The maximum incidence was in the 6th decade. Dysphagia was the predominant symptom and loss of weight was the predominant sign. The diagnosis is based on barium contrast radiology and endoscopy. Lower 1/3, 36% in middle 1/3 and 13% in upper 1/3. Squamous cell ca. constituted 80% in upper 2/3 and 40% in lower 1/3 while adenocarcinoma comprised 35% in lower 1/3 and less than 3% in upper 2/3. Surgical exploration was carried out in 62.8% cases, but resections was possible in only 24.4%, respectability was highest in the lower 1/3 [40.2%] and least in the middle 1/3 [7%]. The overall resection mortality was 30.5% for transthoracic excision mostly due to anastomotic leakage and mediastini were in lower 1/3, 36% in middle and 13% in upper 1/3. Squamous cell ca. was 75%, while the mortality for blaunt oesophagectomy without thoracotomy was 14%. The middle 1/3 lesions were most difficult to treat with very low resectability and prohibitive mortality with either surgical resection [62.5%] or surgical by pass [57%]