Overview of the current management of carcinoma of the esophagus and cardia.

Esophagogastrectomy with esophagogastrostomy provides the best palliation for patients with carcinoma of the esophagus and cardia. It affords better palliation, longevity and overall survival than do other forms of therapy either singly or in combination. Treatment span is short, the patient is able to return to a reasonably normal life-style relatively quickly and the debilitating effects of dysphagia are relieved in most patients. Between January 1970 and July 1984 at the Lahey Clinic Medical Center, the overall operability rate was 80.3% and the resectability rate 87.2%. Four of 191 patients who underwent resection died for a hospital death rate of 2.1%. The overall 5-year survival rate was 16.3% and 81.2% of patients had successful palliation of dysphagia.