Cancer of the esophagus and cardia. Role of surgery in palliation.

Palliation will remain the goal of therapy for cancer of the esophagus and cardia until early diagnosis permits improvement in long-term survival rates. Of the various surgical and nonsurgical techniques available for palliation, I prefer resection with esophagogastrostomy. This procedure can now be applied to most patients, with relatively low mortality and morbidity rates. The period of treatment is short compared with the time required for other forms of therapy, and satisfactory palliation can be achieved in nearly 85% of patients, with better survival rates than for other forms of therapy. Resection is the only method of treatment that provides any reasonable hope for cure. The overall five-year survival rate in my series is 21.6%. For early stage I lesions, the five-year survival rate is 43.4%.