J.Jpn. Surg. Soc.. 83(9): 865-868, 1982

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Report on the annual meeting

SURGICAL RESECTION OF ESOPHAGEAL CARCINOMA INVADING NEIGHBORING ORGANS

To determine the effectiveness of surgical resection of esophageal carcinoma invading neighboring organs, 151 cases of A3 esophageal carcinoma resected at National Cancer Center Hospital were analyzed according to many factors. Prognoses of the cases which received incomplete resection of the tumor were poor. Some cases, which received resective operation after pre-operative irradiation and post operative irradiation was also conducted, showed better prognosis. Lymph node metastasis was an indicator of the patient's prognosis.
If the metastases were present at distant lymph nodes, prognosis was pessimistic. So it is important to determine lymph node metastasis accurately before operation. Ultrasonic diagnosis is one method to detect the lymph node metastasis in the abdominal cavity.
Mediastinal lymphoscintigram with ^99mTc Rhenium Sulfar colloid is also a better and simple method to detect distant lymph node metastasis. We showed the results of 14 cases conducted this method and emphasized the effectiveness of this method. Age was another factor to consider the resection of A₃ cases, because the patients over 70 years who received resection for A₃ carcinoma did not show any 3 year survivar.
Resectability must be considered carefully with X-ray findings before decision of resection.

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