[Multimodality treatment of thoracic esophageal carcinoma].

Current multimodality treatment of thoracic esophageal carcinoma in our institution was described. The rate of superficial carcinomas is increasing in recent years, and they are treated by endoscopic mucosal resection (EMR), transhiatal esophagectomy (THE) or with the thoracotomy approach. Treatment is based on precise diagnosis of the depth of cancer invasion and nodal involvement using endoscopy with endoscopic ultrasound (EUS). Three-field lymphadenectomy for thoracic esophageal carcinoma, including superficial one, was started in 1983 as a standard operation, and its indications have been gradually decreasing for the past 10 years. As a result of accurate, individualized treatment, life table analysis revealed no significant difference between 2- and 3-field lymphadenectomy. Multimodality treatment of advanced cases is mainly composed of 3-field lymphadenectomy. Adjuvant chemotherapy of systemic therapy is regarded as more important than concurrent irradiation of local therapy. Recently powerful chemotherapy is becoming more frequent pre- or postoperatively. Our routine regimen is CDDP and infusional 5-FU with leucovorin as a biochemical modulator.