Surgical treatment of carcinoma of the esophagus and cardia among the Chinese.

Clinical data on 1,450 patients with epidermoid carcinoma of the esophagus and 727 with adenocarcinoma of the cardia (seen from 1952 to 1980) are presented, with the results of surgical treatment in 387 epidermoid carcinomas and 164 adenocarcinomas. The rates of resectability, postoperative complications, and surgical mortality were 44.3%, 28.5%, and 5.1% in epidermoid carcinoma and 39.6%, 17.4%, and 5.9% in adenocarcinoma, respectively. Five-year survival after resection was 11.9% in epidermoid carcinoma and 6.7% in adenocarcinoma. The operative procedure is described. According to our experience, extensive resection of the esophagus followed by reconstruction of the alimentary tract with esophagoileocoloplasty or esophagogastrostomy retrosternally for the epidermoid carcinoma appears to be the treatment of choice. For adenocarcinoma of the cardia, resection of the tumor and esophagogastrostomy or esophagojejunostomy, can be done transthoracically if the esophageal involvement is not high. In any case, early diagnosis and early treatment are the only ways to improve the present results.