Clinicopathological study of esophageal carcinomas treated with preoperative radiation

Fifty-three patients with esophageal squamous cell carcinoma were treated with preoperative radiation. The ratio of men to women was 2.1:1. The most common site was the middle part of esophagus (73.6%), followed by the lower part (18.9%) and the upper part (7.5%). Histology revealed well differentiated carcinoma in 28.3%, moderately differentiated carcinoma in 62.2%, and poorly differentiated carcinoma in 3.8%. According to cancer depth, invasion to the adventitia was the most common (79.2%), followed by submucosa in 1.9%, and muscularis propria in 13.2%. In comparison with the non-irradiated group, macroscopically tumorous and superficial types were less common in the irradiated group. Furthermore, cancer 5 cm or more in size and moderately differentiated carcinoma were decreased by irradiation. Preoperative irradiation for cancer tissues was considered extremely effective in 20.7%, fairly effective in 30.2%, and slightly effective in 34%. However, it is unpromising for distant lymph node metastasis, although vascular involvement slightly improved. (N.K.)