Gastrointestinal surgery and gastroenterology. III. Diagnosis and treatment of esophageal carcinoma]

Some 900 new cases of oesophageal carcinoma occur annually in the Netherlands. The proportion of adenocarcinomas has increased to 41% in 1989-1992, probably in connection with the increasing incidence of Barrett oesophagus. The diagnosis of oesophageal carcinoma is made on the basis of endoscopical biopsy and histological examination. Staging is done by means of endoscopical ultrasonography for the T and N stages, and CT and external ultrasonography for the M stage. Treatment with curative intent consists of surgical resection, which may be combined with chemotherapy and/or radiotherapy. The 5-year survival rate ranges from 70-90% for a stage I tumour to 5-11% for a stage IV tumour. If a short survival is expected, palliative therapy may improve the passage of food. The palliative therapies used most in the Netherlands are introduction of a self-unfolding endoprosthesis or brachytherapy.