Pate J W, Eastridge C E, Casini M P
Am Surg. 1983 Feb;49(2):90-3.
Carcinoma of the esophagus, the fourth most common malignant tumor of the gastrointestinal tract, still has a dismal outlook. Since July 1960, we have collected data on 642 patients with this lesion. Adenocarcinomas (which might arise from gastric mucosa) have been excluded. Almost one-fifth of the patients were far-advanced and inoperable when first diagnosed. Time between onset of symptoms and diagnosis was deemed excessive in over half of the patients; physicians frequently accounted for much of this delay. Preoperative diagnosis proved accurate in 99 per cent of the cases. Evaluations of direct extensions and distant metastases and attention to nutritional status correction were of prime importance. Operative technique and indications for surgery have become "standardized," and while surgical mortality has remained about 20 per cent throughout the period, morbidity has decreased steadily. Comparisons of irradiation and surgery in relation to palliation indicate that palliation is probably better in the surgically treated patient. However, it is emphasized that this comparison, as well as comparison of other results, is not scientifically valid since the groups of patients are not comparable due to clinical selection.
食管癌是胃肠道第四常见的恶性肿瘤，其预后仍然不容乐观。自1960年7月以来，我们收集了642例患有这种疾病的患者的数据。腺癌（可能起源于胃黏膜）已被排除在外。近五分之一的患者在首次诊断时已处于晚期且无法手术。超过一半的患者从症状出现到诊断的时间过长；医生常常是造成这种延误的主要原因。术前诊断在99%的病例中被证明是准确的。评估肿瘤的直接扩散和远处转移以及关注营养状况的纠正至关重要。手术技术和手术指征已经“标准化”，虽然在此期间手术死亡率一直保持在20%左右，但发病率却在稳步下降。关于缓解症状的放疗与手术的比较表明，接受手术治疗的患者症状缓解可能更好。然而，需要强调的是，由于临床选择导致患者群体不具有可比性，所以这种比较以及其他结果的比较在科学上是无效的。
