Advanced esophageal carcinoma

摘要: From 1976 until 1990 a total of 212 patients with squamous cell carcinoma the thoracic esophagus were referred for surgical treatment. Resectability was 84.1% (161 191). Actuarial 5-year survival in negative lymph nodes 51.2% versus 12.4% nodepositive patients. Therefore advanced defined to compromise all involved regional (N1) or distal (M+Ly) as well T4 tumors solid organ metastasis (M+org) irrespective their node status. Comparing complete (R0) incomplete (R1–R2) resections stage III and IV revealed 20% 0% five-year survivals, respectively. There no group. When excluding metastasis, median shifted from 8.5 months after 20 resection. In 1991 three-field lymphadenectomy initiated that included bilateral cervical lymphadenectomy. Thirty-seven have been treated so far (23 carcinoma, 14 adenocarcinomas). Cervical positive 24.3% an incidence up 28.5% distal-third carcinoma. Subsequently, 6 (16%) moved M0 M+Ly Our results confirm key role surgery not only improving locoregional tumor control but refining accuracy staging carcinomas provided resection is possible. Nowadays other options treatment are mainly based on neoadjuvant chemoradiotherapy response rates ranging 40% 60% now without evidence improved local distant failure approximately 30% 45%, For clinically nonresectable (T4) presumed tumors, therapy seems important role, it may convert these into resectable therefore potentially curable cancers. Toxicity remains drawback, probably responsible preoperative dropouts slight definitive higher postoperative mortality morbidity. disease clearly incurable, best today laser endoprosthesis, which result good relief dysphagia 80% 85% procedure-related below 5%.