J.Jpn. Surg. Soc.. 81(9): 1035-1038, 1980
Report on the annual meeting
THERAPY OF ESOPHAGEAL CARCINOMA BASED ON PREOPERATIVE X-RAY FINDINGS
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Institute of Gastroenterology, Tokyo Women's MedColical lege Akiyoshi Yamada, Seiichiro Kobayashi, Hiroko Ide, Tomomi Ogino, Mitsuo Endo |
The resectability of a lesion is determined by the depth of invasion and by the presence or absence of lymph node metastases.
The significant factors are its grors morphology, the character of its margin, and the depth of ulceration. Unfortunately, the depth of invasion is not necessarily directly related to the prognosis. In some carcinomas confined to the submucosa, lymph node metastases are already present, and these patients have a poor prognosis.
To improve the prognosis of esophageal carcinoma, it is necessary to establish its therapy based on spreading of esophageal carcinoma.
So, we should consider two ways of spreding, i.e., one is local one and the other metastatic one. With regard to treatment, operation and irradiation belong to local one, and chemo-immunological one to systemic one.
To improve the prognosis, we should utilize both of them. Therefore, we discuss, in this paper, imfiltration into the adventitia and lymph node metastarsis based on X-ray findings. Distant metastases are often found in cases of superficial carcinoma will iregularity of the surface and the presence of a complex lesion, rigid tiny ulcerative type, multicentric ulcerative type, ill-defined ulcerative type, tumorous scirrhous type, and infiltrating type.
The prognosis of these types is very poor regardless of the method of treatment, and therefore ‘agressive’ therapy toward to both primary and metastatic lesions is necessary to improve their prognosis.
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