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J.Jpn. Surg. Soc.. 90(9): 1410-1413, 1989


Report on the annual meeting

ROLE AND SIGNIFICANCE OF EXTENDED OPERATION IN THE TREATMENT OF STAGE IV CARCINOMA OF THE ESOPHAGUS

Department of Thoracic and Cardiovascular Surgery, University of Occupational and Environmental Health

Hideyuki Kawahara, Shigetoh Odagiri, Hiroki Ishikawa, Akio Yoshida, Yoshiya Ishikura, Hiroshi Yoshimatsu

A total of 106 cases of esophageal cancers treated in our hospital between Jan. 1980 and Jan. 1989 were studied to evaluate the role and significance of extended surgical resectin in the treatment of the stage IV patients with T3 tumors. Of those treated were included six patients of stage 0, four of stage II, twenty-nine of stage III, and fifty-two of stage IV. Resectability rate was 82.1%, direct death rate was 8.0%. An overall one-year and three-year survival rate were 54.0% and 21.8%, and those of stage IV were 26.6% and 6.4% respectively. For thirty-one of the 52 patients with T3 tumor, combined radical resection of the structures were performed, with a mortality rate of 12.9%, and a mean survival period of 720.2 days for n0, 239.5 days for n2 (+) and 299.4 days for n3-4 (+). Mean survival of the patients without combined resectin of the involved structures were 465 days (n0), 156 days (n2) and 236 days (n3-4) respectively. The organs resected included the trachea (17), thoracic aorta (7), carotid artery (4), pericardium (4), lung (3) and so on. It is concluded that improved survival for even advanced T3 carcinomas especially without lymph nodes metastasis might be obtained by the combined radical resectin of the involved neighboring structures.


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