Carcinoma of the Esophagus

Parker, Edward F.; Gregorie, Henry B.; Arrants, Jack E.; Ravenel, James

doi:10.1097/00000658-197005000-00014

Cited by 41 publications

(12 citation statements)

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“…The perioperative mortality of 32% is in keeping with reported series from similar institutions (Parker et al, 1970) (i.e., resident surgeons performing esophagogastrectomy). The high incidence of complications is outlined.…”

Section: Methodssupporting

confidence: 85%

“…This mortality rate averages 20% in centers doing a large volume of this type of surgery. There is wide variation in this figure, however, with extremes of 16% (Clifton, 1970), to over 50% (Maillard et al, 1969;Parker et al, 1970). In institutions limiting resection The statistics above apply only to squamous cell lesions, which predominate to lesions of the lower third of the esophagus, lower mortality rates are reported (Leon et al, 1971).…”

Section: Methodsmentioning

confidence: 99%

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Esophageal cancer: Results of therapy in an indigent population

Buck

Fletcher

1973

Journal of Surgical Oncology

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The Tumor Clinic charts of 118 patients with esophageal carcinoma were reviewed. Of these patients 101 had squamous cell carcinoma. All were from an indigent patient population, and had a high rate of alcoholism, heavy smoking, and malnutrition. Most of the patients presented with dysphagia or pain. However, on review, significant weight loss antedated these symptoms by many months. Earlier diagnosis might be achieved in many instances by a careful esophageal workup in those patients with unexplained weight loss. The duration of dysphagia does not correlate with length of survival after therapy. The data indicates that esophagectomy offers the best chance for cure, and longer significant palliation. The significant morbidity and mortality of this procedure in the malnourished patient can be minimized only by careful attention to operative technique. An experienced senior surgeon should attend this procedure when it is performed by resident surgeons in a teaching situation. Radiotherapy should be reserved for use as an adjuvant to surgery preoperatively, or for patients whose associated disease precludes surgical resection.

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Section: Methodssupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Esophageal cancer: Results of therapy in an indigent population

Buck

Fletcher

1973

Journal of Surgical Oncology

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“…Several workers have attempted to improve longterm results by combining surgery with radiotherapy and reports of the outcome of such efforts have been appearing during the past 20 years (Cliffton and Blansfield, 1953 ;Anahtawi, hackney, and Ellison, 1964;Guernsey, Donnett, Mason, Kotatsu, and Oberhelman, 1969;Parker, Gregorie, Arrants, and Ravenel, 1970). The advantage of this procedure is not obvious and it is a definite disadvantage that treatment is prolonged and elaborate.…”

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confidence: 99%

Surgical treatment of carcinoma of the oesophagus and cardia

Collis

1971

British Journal of Surgery

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SUMMARYExperience in the management of a personal series of 837 cases of carcinoma of the oesophagus and cardia is described. It is evident from this that the subject is not a static one. Improvement is occurring and there are good reasons to expect this to continue. The aspects affected by this improvement include morbidity, mortality, the well-being of patients, and the long-term survival. Unfortunately, in the majority of cases, treatment is only palliative, but palliation is good and it relieves the patient of his main symptom-dysphagia.In view of the great benefits which good palliation provides, no treatment can be considered as satisfactory unless the relief of symptoms is of a high standard.It is maintained that too much emphasis has hitherto been placed on long-term survival, which is only possible in the minority of cases.Bearing all factors in mind a strong case can be made for the overall surgical plan in the management of growths affecting the middle and lower parts of the oesophagus. all demonstrate a similar theme. With determined effort and the experience which comes from handling these cases in large numbers, the growths can be removed with a low level of morbidity and a mortality which is not too oppressing. It is also clear that improvement is still continuing. Operative mortality varies from 5 to 30 per cent and late results range between 10 and 25 per cent of operative survivors still alive at 5 years after operation. It seems reasonable to conclude that unless the operative mortality can be brought down to approximately 10 per cent and unless morbidity is low there is a tendency for radiotherapy to be preferred to surgery.Several workers have attempted to improve longterm results by combining surgery with radiotherapy and reports of the outcome of such efforts have been appearing during the past 20 years (Cliffton and

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“…The life tables computed from the registry are based on 486 patients with histologically proven squamous cell carcinoma of the esophagus followed up to five years and with 394, or 81% traced definitively. Many of these patients have appeared in the statistical series of Parker et al (1970).…”

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confidence: 61%

Carcinoma of the esophagus

Rambo

O’Brien

Miller

et al. 1975

Journal of Surgical Oncology

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Life tables were computed from the Tumor Registry at the Medical University of South Carolina on 486 patients with histologically proven squamous cell carcinoma of the esophagus. The 5-yr follow-up was available in only 394 patients, or 81% of the total sample. For purposes of comparison with published literature, the traditional crude 5-yr survival percentages in the life-table analyses figures are presented. The life-table calculation utilizes all follow-up information available, in that patients observed for less than 5 yr still may contribute to the estimate of the true 5-yr survival rate in contrast to the past when all patients lost to follow-up were presumed to have died. In this method, patients not observed for the full time of the study are assumed to have had the same risk of dying as patients followed to the end of the fifth year experienced in their fifth-year analyses. The group with the most favorable prognosis in this series was that receiving preoperative irradiation. This operation. They were given 4,500 rads of supervoltage X ray over a period of 3 weeks prior to operation. The differences in surgical or radiation techniques employed by various reporters make comparative data difficult, if not impossible, to evaluate. Supervoltage irradiation has proved itself in some hands equal to surgery. A randomized prospective study would seem appropriate to conclude the best means of managing epidermoid carcinoma of the esophagus.

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Carcinoma of the Esophagus

Cited by 41 publications

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Esophageal cancer: Results of therapy in an indigent population

Esophageal cancer: Results of therapy in an indigent population

Surgical treatment of carcinoma of the oesophagus and cardia

Carcinoma of the esophagus

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