Surgical treatment for malignant lesions of the distal part of the esophagus and the esophagogastric junction

The treatment of 364 patients with carcinoma of the distal part of the esophagus and the esophagogastric junction is reported. Eighty‐two percent of the patients were subjected to operation and the resect ability rate was 52%. At operation 230 patients had lymph node metastases and 115 patients had distant metastases to abdominal organs. The resection rate was significantly higher in patients with squamous cell carcinoma than in patients with adenocarcinoma, and about two‐thirds of the resections were considered as “curative” treatment. The operative mortality rate for the entire period was high (24%), but the mortality decreased in the last 10‐year period. The 5‐year survival rate after resection was in the same level as in other series; the survival rate for patients with squamous cell carcinoma was considerably higher than for patients with adenocarcinoma. If surgical resection is not feasible, surgical bypass of the obstructing lesion is indicated. This alternative procedure gives satisfactory palliation in the majority of patients.