Carcinoma of the oesophagus and gastric cardia at autopsy in Finland.

154 patients in 16,523 consecutive autopsies had carcinoma of the oesophagus or gastric cardia. Thirty-three of these patients had had an oesophagogastric resection, 33 radiation therapy and 88 no effective therapy. In 47% of the cases given effective treatment (66 cases) no tumour tissue was detected at the autopsy. 20% of patients with no effective therapy had a localised tumour. Most of the localised tumours were in the lower third of the thoracic oesophagus. When an oesophageal or cardiac carcinoma without effective therapy was no longer localised, it was more than twice as likely that the tumour had already spread in combined ways. The localised stage and the local invasion of the tumour were to some extent dependent on the length of the tumour, but distant metastasizing was not dependent on it. 84% of the cases had direct or indirect complications caused by the tumour. The patients with oesophageal carcinoma had died twice as often of tumour complications than of metastases, whereas cardiac carcinomas led to death from metastases considerably more often than from tumour complications. The series included three cases of aorto-oesophageal fistula.