[The mode of recurrence of esophageal cancer after surgical treatment--autopsy study].

The results of clinical examinations, operative findings and autopsy findings of 113 patients submitted to esophagectomy were evaluated in terms of their correlations. Tumor was absent in 45 patients at autopsy. Of the remaining 68 cases, lymphnode metastases were present in 56 cases, metastases to the distant organs in 39, pleural and/or peritoneal disseminations in 15, direct extensions into the adjacent structures in 31, involvement of anastomotic site in 11 and intramural metastases to the esophagus and/or stomach in 9 cases. Lymphnode metastases were noted in autopsied cases even though death occurred shortly after surgery. Sixteen of these 51 patients had lymphnode metastases, 9 in the paratracheal or parabronchial , 6 in the abdominal, 5 in the supraclavicular and 4 in the posterior mediastinal nodes. Tracheobronchial tree and thoracic aorta were the commonest neighboring organs affected by direct extension. Local recurrences were noticed most frequently in cases where carcinoma extended to the deep border of the surgically resected specimens. Local recurrences were suppressed in those who received preoperative irradiation. The results suggested a possibility of improving the survival rate by 4% by combined resection, 10% by extended radical lymphnode dissection and 19% by both procedures.