“…If the length of the tumour is less than 5 cm, 50 per cent will have developed lymph node metastases and, if nerve palsy are obvious later signs of local spread. In assessment of operability most authors ignore the length of the tumour, ESR, scalene node biopsy (1 52, 157,158), coeliac axis node biopsy and evidence of mediastinal spread by tomography or mediastinoscopy .…”
Authors writing an oesophageal cancer include adenocarcinoma to a variable extent--between 1 and 75 per cent--but the true incidence of this histological type is about 1 per cent. Most adenocarcinomas are gastric in origin, involving the lower oesophagus, have a lower operative mortality than in the middle or upper one-third of the oesophagus and poorer prognosis than squamous cell carcinoma, but there is no alternative treatment to surgery. Squamous cell carcinoma of the oesophagus, separated incompletely but as far as possible, has been analysed by reviewing data on 83 783 patients in 122 paERS. After trying to standardize the data, it appears that of 100 patients with the condition, 58 will be explored and 39 have the tumour resected, of whom 13 will die in hospital. Of the 26 patients leaving hospital with the tumour excised, 18 will survive for 1 year, 9 for 2 years and 4 for 5 years. Oesophageal resection for squamous cell carcinoma has the highest operative mortality of any routinely performed surgical procedure today.
“…If the length of the tumour is less than 5 cm, 50 per cent will have developed lymph node metastases and, if nerve palsy are obvious later signs of local spread. In assessment of operability most authors ignore the length of the tumour, ESR, scalene node biopsy (1 52, 157,158), coeliac axis node biopsy and evidence of mediastinal spread by tomography or mediastinoscopy .…”
Authors writing an oesophageal cancer include adenocarcinoma to a variable extent--between 1 and 75 per cent--but the true incidence of this histological type is about 1 per cent. Most adenocarcinomas are gastric in origin, involving the lower oesophagus, have a lower operative mortality than in the middle or upper one-third of the oesophagus and poorer prognosis than squamous cell carcinoma, but there is no alternative treatment to surgery. Squamous cell carcinoma of the oesophagus, separated incompletely but as far as possible, has been analysed by reviewing data on 83 783 patients in 122 paERS. After trying to standardize the data, it appears that of 100 patients with the condition, 58 will be explored and 39 have the tumour resected, of whom 13 will die in hospital. Of the 26 patients leaving hospital with the tumour excised, 18 will survive for 1 year, 9 for 2 years and 4 for 5 years. Oesophageal resection for squamous cell carcinoma has the highest operative mortality of any routinely performed surgical procedure today.
“…There are conflicting views about the primary aim of resection. Some authors consider palliation to be the main goal of resection [4,7,14,15], while others advocate resection to achieve permanent cure of the disease [16,17]. We practice radical resection and lymphadenectomy whenever feasible in an attempt to cure the patient.…”
During the period 1962–1976, 196 patients were operated on for carcinoma of the esophagus (51) and cardia (145). In all patients resection with primary esophagogastrostomy or esophagojejunostomy was performed. Metastases involving the regional lymph nodes were found in 54.2% of patients. The early postoperative mortality rate was 21.9%. The most common cause of death was leakage at the esophagogastric anastomosis (46.5% of deaths). Mean survival period was 16.2 months, overall 5‐year survival rate was 18.7%, and 5‐year survival rate excluding early post‐operative mortality was 21.7%. Mean survival period in patients who had resection of the esophagus with negative lymph nodes was 13.5 months and in those with positive nodes was 8.1 months. Mean survival time in patients after resection of the cardia was 19.7 months if nodes were negative and 8.2 months if nodes were positive.
The most frequent cause of late death was advanced cancer and distant metastases. Postoperatively, most patients were able to adopt their previous mode of life. All living patients but 1 are ambulatory, 2/3 perform work that is the same as or easier than that prior to the onset of the illness, they have no difficulty in consuming food, and are physically fit. The most common side effect was heartburn due to reflux esophagitis.
“…There were 18 awards for topics in general thoracic surgery (Table 3) [2,4,8,9,13,15,16,20,21,26,29,36,40,41,47,51,52,54]. Their clinical impact was significant.…”
The President's Award for best scientific paper is presented to esteemed members at each Southern Thoracic Surgical Association annual meeting to stimulate friendly scientific competition. Between 1964 and 2015, 58 awards were presented for clinical expertise in general thoracic surgery (18), adult cardiac surgery (25), and congenital heart surgery (15). Manuscripts were published by The Annals of Thoracic Surgery, and the average number of subsequent citations in professional medical journals as a measure of scientific importance was 43.7 ± 60.2. A seemingly prosaic addition of a yearly scientific award has had an enormous impact on the scientific community and membership participation.
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