Palliation for esophageal carcinoma

Fifty-three patients with carcinoma of the esophagus treated since 1972 are reviewed. Eighteen unresectable patients with distant metastases or pulmonary insufficiency were treated with irradiation or with esophageal or gastrostomy tubes plus irradiation. There were 5 early deaths, and only 3 patients survived more than three months. Six patients underwent bypass. Three died in the hospital, and 1 lived three months. None compled a course of irradiation or gained weight. The remaining 29 patients, who did not differ clinically from the bypass group, underwent resection for palliation or cure. There were 5 hospital deaths. Twenty patients lived more than three months and 7 of these more than one year. Two of them apparently were cured. These data indicate that the only effective means of increasing the duration of survival for esophageal carcinoma is resection with immediate reconstruction.