SURGICAL TREATMENT AND ITS RESULTS OF ESOPHAGEAL CANCERS AT OUR INSTITUTION IN A RECENT ONE DECADE

Surgical treatment and the results of esophageal cancers at our institution in a recent one decade were analyzed with special reference to the combination chemo-radiation therapy. Eighty-one patients who underwent esophagectomy for esophageal cancer were divided into two patient groups; the first half group (1981-1985: 28 patients) and the last half (1986-1991: 53 patients). The first half group received radical esophagectomy including 2-field lymph node dissection with preoperative irradidiation (30Gy). The last half received 3-field lymph node dissection with preoperative chemotherapy (CBDCA, 5FU and PEP) and postoperative irradiation (45Gy) combined with chemotherapy. In the last half, 56.8% received 3-field lymph node dissection and 51.0% received combined chemotherapy. No difference in the operative mortality rate was observed between the groups. Side effects of chemo-radiation therapy were pharyngitis and leucocytopenia. The five-year survival rate of over-all patients who received esophagectomy were 20.9% in the first half and 32.2% in the last half. The five-year survival rate of patients receiving curative operation were 25.0% in the first half and 48.4% in the last half. Postoperative anastomotic disruptin was improved from 39.4% to 9.4% by the modification of the procedure in the last half. In conclusion, our pre-and postoperative chemo-radiation therapy combined with 3-field lymph node dissection can be safely applied without severe side effects to the patients with esophageal cancer, and was effective to improve the survival rate.