| Abstract: | ![]()
Eighty-eight cases of cancers of the cervical esophagus were treated at the Institut Gustave-Roussy (France) between 1968 and 1980. They included 67 epitheliomas of the esophageal opening excluding those of the hypopharynx extending into the esophagus, and 21 epitheliomas of the actual cervical portion of the esophagus. Whenever possible, basic therapy was by radiotherapy (64 cases). There were no survivors after 2 years, possible explanations for this poor result being the selection criteria for treatment, the choice of radiotherapy as basic treatment, and the doses employed. A new therapeutic approach is suggested following a pathological study and an analysis of the different therapeutic possibilities available. Pre-operative chemotherapy is followed by total laryngopharyngectomy with total esophagectomy without opening of the thorax, performed under certain well defined conditions. Continuity is reestablished by gastropharyngostomy and postoperative radiotherapy is applied systematically. This therapeutic approach involving major surgery is applicable only for selected patients, others having to be treated by combined radiotherapy and chemotherapy alone. |
