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March 8, 1976

Dilemma of Esophageal Carcinoma

Author Affiliations

Columbus, Ohio

JAMA. 1976;235(10):1044-1045. doi:10.1001/jama.1976.03260360046029

Approximately 6,000 of the 350,000 deaths from cancer in this country are due to carcinoma of the esophagus. Aggressive and progressive application of surgical and radiation therapy in the last half century has not resulted in an anticipated high cure rate, and the overall long-term survival of patients with this disease is less than 2%.

This neoplasm, predominantly of the squamous cell type, is relatively slow-growing, and total eradication should be feasible in its early stages prior to local and distant extension and metastasis. The problem is the difficulty in establishing an early diagnosis. Dysphagia, the most common initial symptom, usually does not occur until the carcinoma has reached a large size and there is involvement of the entire circumference of the esophagus. The diagnosis of carcinoma of the esophagus, once suspected, is established without difficulty by roentgenographic contrast studies and endoscopic biopsy of the lesion. Regional extension and distal