SURGICAL-TREATMENT FOR CARCINOMA OF THE ESOPHAGUS IN CHINESE-LANGUAGEPUBLICATIONS

Introduction This review is a meta-analysis of Chinese language public ations on surgical treatment for oesophageal cancer. Methods Between 1 980 and 1994, 17815 patients had surgery for carcinoma of the oesophag us. The male:female ratio was 3.9:1 and mean age was 51.9 (range 16-80 ) years. Results Mean resectability rate was 86.7 per cent and hospita l mortality rate was 3.8 per cent. The crude 5-year and 10-year surviv al rates for all patients were 29.6 and 16.4 per cent respectively. Fo r patients with stage 0 and stage I tumours, the 5-year survival rate was 95 and 89 per cent respectively, significantly greater than that f or those with stage II, III and IV tumours (19.4 per cent, P < 0.01). The 5-year survival rate of all 2226 patients with tumour resection af ter radiotherapy was 38.0 per cent. There was no significant differenc e in survival following combination therapy compared with surgery alon e. When compared with a report for the interval 1940-1979, there was n o significant difference in the resectability, hospital mortality or 5 -year survival rates. Conclusion Oesophageal carcinoma remains a disea se with dismal prognosis but surgery still offers the best chance of l ong-term survival. Adjuvant therapy has not yet proved an advantage in terms of survival but can be useful for palliation. Mass screening mi ght improve survival but only in a population with a high incidence of oesophageal carcinoma.