Abstract
As treatment for esophageal cancer, radiotherapy was the mainstream in the 1950s and 1960s; however, the 5-year survival rate was only 4.3%. Surgical treatment was introduced in the clinical field by K. Nakayama and other surgeons in the late 1960s, and the 5-year survival rate increased to over 20%. Thanks to improvements in diagnostic capability, resectable cases without preoperative irradiation increased in number. Then surgical treatment was performed first, followed by post operative irradiation. The 5-year survival rate improved to 30-40%, but recurrence of upper mediastinal and cervical lymph nodes could not be controlled. Three-field lymph node dissection was employed in the 1980s, after which the 5-year survival rate increased to 50-60%. Moreover, endoscopic resection (EMR, ESD) came to be employed in early esophageal cancer cases in which invasion is limited to the mucosal layer. With development of cisplatin, chemo-radiotherapy (CRT) had also been carried out extensively, and its 5-year survival rate is 30-40%.
In esophageal cancer patients, elderly persons constitute a large number and patients who have double or triple cancers in other organs account for about 30%. This makes decision of treatment strategy for esophageal cancer extremely difficult. Further progress is desired in diagnosis and treatment of esophageal cancer.
