Carcinoma of the esophagus. An autopsy study of 231 cases.

Autopsy findings for 231 cases of carcinoma of the esophagus are presented. Cases with tumour resection constituted 57% of the series. Residual malignancy was present in 81% of all cases. Local residual or recurrent tumour was found in 53%, lymph node metastases in 65% and visceral metastases in 54% of cases. Intrathoracic lymph node metastases were present in 41% of patients after tumour resection and were probably significant in the failure of radical surgery. Adequate clearance of intrathoracic lymph nodes during radical surgery may reduce the incidence of tumour recurrence in this group of patients. Survival was poor in patients with or without resection of the primary tumour. Less than 12% were alive 1 yr after presentation. The average duration of dysphagia at presentation was 2.5 mth. The poor survival of our patients suggests that, by the time they presented clinically, the disease was already advanced. Early disease detection is important for a chance of cure in patients with esophageal cancer.