The surgical treatment of squamous cell carcinoma of the oesophagus in Singapore.

Abstract

In a retrospective study, we reviewed 97 consecutive cases of squamous cell carcinoma collected over a five-year period (1978-1983). Resection of the tumour was possible in 30 out of 40 patients subjected to surgery. Of these 30 patients, five died within 30 days of surgery. Eight patients who underwent oesophageal resection were still alive after five years and apparently cured. Bypass surgery for unresectable lesions in six patients were complicated by anastomotic leakage in three patients. Patients unsuitable for surgical resection were treated using Celestin tube insertion or radiation. Mean survival in 13 patients with Celestin tube insertion was 4.1 months. Of 48 patients who were treated by radiotherapy, two lived beyond five years. Surgical resection restores swallowing effectively and offers a 25% chance of cure and should be done in fit patients. In unfit patients with advanced disease, palliation from the use of radiotherapy and Celestin tube insertion were poor. Newer techniques such as endoscopic laser recanalisation and bicap hyperthermia may need to be considered for palliation in this group of patients.