Abstract
Recently, prognosis of patients with esophageal carcinoma has greatly improved in Japan. It may largely owe to the early detection of tumor by an advanced endoscopic technique and to the enlarged surgical field. Correct tumor staging by CT scanning, endoscopical and percutaneous ultrasonographies did a lot for accurate selection of the treatment, which consequently have contributed to improve overall patient prognosis. According to the report of national registration in Japan, percentage of superficial carcinoma in total esophageal tumors has increased by more than double time in the last ten years resulting in 28%. This increased number of early stage tumor gives impetus to the evolution of endoscopic mucosal resection (EMR). Using Lugol-staining method, EMR has a definite role today in the treatment system of esophageal carcinoma. While, a study to examine whether chemo-radiation therapy can be a treatment with curative intent or not for patients with early stage tumor has started. The standard treatment for esophageal carcinoma has been surgery, and nearly 80% of patients have undergone it in the last ten years. Around 18 years ago, a technique of 3-field lymph node dissection was introduced to an esophagectomy, which has become a part of the standard technique of esophagectomy in many leading institutions in Japan, By these advances, postoperative survival rate for patients with esophageal carcinoma in our institute has reached to 50%. Reduction of the surgical burden and development of new treatment strategies in the place of surgery are assignments for us in the future.
