Approach to the Treatment of Esophageal Cancer

Toshio Mitomi

Department of Surgery, School of Medicine, Tokai University

In this paper, treatments of esophageal cancer was described, in which our department has been involved for twenty years. Since radiotherapy was first introduced to treat it, it has been gradually recognized that surgery is more effective than radiotherapy. Shortly after the introduction of surgery, main issue was to improve its resectability. Then, a wide lymph node dissection of cervical, thoracic, and abdominal lymph nodes has been often performed. Now, most suitable treatment can be chosen among a variety of treatment modality for a patient of a certain disease state, since early esophageal cancer has increased in number. According to the reports of superficial esophageal cancer by Nabeya, Mitomi and Endo, mucosal cancer has gradually increased. In our institution, superficial cancer was 25% of all esophageal cancer. tremendous amounts of serial endoscopic findings of ENNG-induced canine esophageal cancer were clinically useful in early detection of esophageal cancer. Furthermore, screening examination on the esophagus was worthy in patients with head and neck cancer or alcohol dependency. As endoscopic mucosal resection for early esophageal cancer was developed, indication of extensive lymph node dissection was determined, results of immunotherapy and chemotherapy were improved, and more accurate diagnosis of a main lesion and lymph node metastasis was developed, new development in treatments of esophageal cancer would be expected in the near future.

Key words
esophageal surgery, treatment of esophageal cancer, endoscopic mucosal resection for esophageal cancer, screening of esophageal cancer, chemically induced esophageal cancncer in canine

Reprint requests
Toshio Mitomi Department of Surgery, School of Medicine, Tokai University
Boseidai, Isehara, 259-11 JAPAN

Accepted
June 14, 1995

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