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Between 1950 and 1964, 596 patients with carcinoma of the esophagus or gastric cardia were hospitalized at the National Cancer Institute in Milan. 224 patients were surgically explored and resection was performed in 137. The resectability rate was higher for tumors of the lower esophagus and gastric cardia than for tumors of the upper and middle esophagus. 36 patients died after resection of the tumor (26.2%). The mortality rate decreased from 38% in 1950–54 to 17% in 1960–64, and it was evident that the larger the tumor the higher was the mortality rate. 17 patients (12.4%) survived 5 years or more. The survival rate was significantly higher in localized tumors, in women, and in carcinomas of the lower esophagus and gastric cardia. Some good results were also obtained for carcinomas of the middle esophagus. Surgery (intubations and bypasses) proved to be a better palliative than radiotherapy for tumors of the lower esophagus and gastric cardia, and gave good results in many cases of carcinoma of the middle esophagus too. Carcinomas of the upper esophagus were better managed by the radiologist than by the surgeon and radiotherapy gave here its best results.
Pizzocaro et al. (Tue,) studied this question.