Treatment and Prognosis
Unfortunately esophageal tumors spread and metastasize early; not more than 25 per cent are surgically resectable at the time of diagnosis. The results of surgery, which is usually carried out only for carcinomas of the lower third of the esophagus, are highly unsatisfactory for cure. There is an operative hospital mortality of about 20 to 30 per cent, and only about 5 per cent survive for five years. On the other hand, resection with reanastomosis often gives considerable palliation from dysphagia, pain, and aspiration. Tumors of the upper and middle thirds of the esophagus are most frequently treated for palliation by irradiation using about 600 rads. Symptomatic relief can sometimes be obtained by dilating a malignant stricture or by placing a plastic prosthetic tube across the site of obstruction.