Transition in Treatments for Esophageal Cancer and their Outcome

Makuuchi Hiroyasu

doi:10.2468/jbes.61.57

As treatment for esophageal cancer, radiotherapy was the mainstream in the 1950s and 1960s; however, the 5-year survival rate was only 4.3%. Surgical treatment was introduced in the clinical field by K. Nakayama and other surgeons in the late 1960s, and the 5-year survival rate increased to over 20%. Thanks to improvements in diagnostic capability, resectable cases without preoperative irradiation increased in number. Then surgical treatment was performed first, followed by post operative irradiation. The 5-year survival rate improved to 30-40%, but recurrence of upper mediastinal and cervical lymph nodes could not be controlled. Three-field lymph node dissection was employed in the 1980s, after which the 5-year survival rate increased to 50-60%. Moreover, endoscopic resection (EMR, ESD) came to be employed in early esophageal cancer cases in which invasion is limited to the mucosal layer. With development of cisplatin, chemo-radiotherapy (CRT) had also been carried out extensively, and its 5-year survival rate is 30-40%.<br>In esophageal cancer patients, elderly persons constitute a large number and patients who have double or triple cancers in other organs account for about 30%. This makes decision of treatment strategy for esophageal cancer extremely difficult. Further progress is desired in diagnosis and treatment of esophageal cancer.

Transition in Treatments for Esophageal Cancer and their Outcome

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