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Surgical treatment combined with preoperative concentrated irradiation for esophageal cancer
Author(s) -
Nakayama Komei,
Orihata Hideo,
Yamaguchi Keizo
Publication year - 1967
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(1967)20:5<778::aid-cncr2820200532>3.0.co;2-b
Subject(s) - medicine , esophagus , esophageal cancer , surgery , survival rate , radiation therapy , stage (stratigraphy) , cancer , lymph node , lesion , esophageal disease , paleontology , biology
When a three‐stage operative procedure was performed in 200 cases of upper and midthoracic esophageal cancer, the operative mortality was 2.5% compared with 9.7% mortality of 236 patients treated by a one‐stage operation. Resectability also was extended with this method. Animal studies of transplanted tumors revealed that amputation of the primary lesion in addition to irradiation, when performed early, provides the most satisfactory result with the longest survival time. Lymph node metastasis associated with surgical manipulation was definitely prevented by preoperative radiotherapy. The effect of irradiation is greater in patients treated with preoperative concentrated irradiation than in those treated with fractional preoperative irradiation. In 191 patients with esophageal cancer 2000 to 2500 rads given over four to five days of concentrated irradiation was most practical and acceptable. This treatment caused no increase in operative mortality, operative difficulty or disturbance in hematopoetic and hepatic function. In those patients with cancer of the upper and midthoracic esophagus treated by irradiation plus surgery the 4‐year survival rate was 31.8% and the 5‐year survival rate was 37.5% in contrast to a 4‐year survival rate of 15.4% and a 5‐year survival rate of 19.1% in those patients treated by resection only. The authors conclude that preoperative irradiation, especially concentrated irradiation, should be added to the surgical treatment of upper and midthoracic esophageal cancer.