Preoperative irradiation for carcinoma of the esophagus.

Preoperative irradiation for carcinoma of the esophagus is tentatively recommended in many, but not all, institutes. For precise appraisal of the effect of preoperative irradiation for carcinoma of the esophagus, the effects of preoperative irradiation, as related to mortality and the long term results, were evaluated in 167 patients who underwent subtotal esophagectomy. Although postoperative pulmonary complications occurred at a higher rate in patients given irradiation preoperatively, the mortality was much the same in irradiation and nonirradiation groups. In 15 (14.4 per cent) of 104 patients given radiation therapy preoperatively, no viable cancer cells were present in the resected tissues and the five year survival rate of these patients was 45.1 per cent. Thus, when the cancer cells are completely damaged, the survival time is extremely enhanced. The findings of our study suggest that the aim of preoperative irradiation should be a complete destruction of the cancer cells.