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Abstract: A 54-year-old man with small cell carcinoma of the esophagus and extensive metastases to the liver and bone is presented herein. Ectopic hormone production and a high level of serum NSE (neuron specific enolase), as revealed by biochemical and radioimmunoassay, suggested that this tumor was derived from the cells of the APUD (amine precursor and dehydroxylation) series. He was treated with a combination chemotherapy, resulting in a prompt remission with significant palliation lasting five months. Small cell carcinoma of the esophagus is as responsive to chemotherapy as small cell carcinoma of the lung. Although this is an uncommon tumor, recognition is important because of its responsiveness to chemotherapy and the potential for significant palliation of symptoms without surgical intervention.

Abstract: Transabdominal resection of esophagocardial cancer and reestablishment of alimentary continuity using by-pass method with gastric tube or colonic segment have been performed in 40 patients including 5 with squamous cell carcinoma. Of 40, 4 cases were at stage II, 8 cases at stage III and 28 cases at stage IV. Major factors which determined the stage were peritoneal dissemination and serosal invasion in the stage IV patients. The removal of the lesion was performed curatively in 13 (33%). Major complications in the post-operative course were the leakage of anastomosis and respiratory failure. Nine of 40 cases (23%) were combined with minor leakage at the cervical anastomosis, but such did not interfere with the resumption of oral ingestion of food. The 3 year survival rate was 46% in the cases of stages (II+III) and 16% in the cases of stage IV, indicating moderately high rates as compared with that in cases of cancer located in the upper third of the stomach with the limited proximal extension within the esophagocardial junction.

Abstract: Transabdominal resection of esophagocardial cancer and reestablishment of alimentary continuity using a bypass method have been performed in 64 patients. Twelve underwent a bypass with a gastric tube and in 30, a colonic segment was prepared. In the remaining 22, a jejunal segment was used as the bypass organ. Leakage of cervical anastomosis occurred in 4 (18 per cent) but all were limited to minor leakage and oral ingestion was resumed within 10 days after operation. In one, necrosis of the jejunal segment occurred. The history of jejunoesophagoplasty was reviewed and the usefulness of jejunal segment as a substitute of an esophagus was emphasized.

Abstract: To investigate the mechanism of tumor growth enhancement induced by operative stress in rats, laparo-thoracotomy was performed on day 2 after tumor cell inoculation associated with administrations of various kinds of immunopotentiators. OK-432 (Streptococcal preparation), PS-K (extract from mycelium of Coriolus Versicolor), Lentinan (extract from Lentinus Edodus) and C. parvum were administered intravenously or intraperitoneally in the fractionated form prior to or after inoculation. In general, administration of each immunopotentiator, except for Lentinan, resulted in a recovery from the reduction in survival days after laparo-thoracotomy. In particular, OK-432 administration prior to inoculation showed a significant improvement.

Abstract: Based on the experimental results that operative stress of thoracotomy or laparothoracotomy has enhanced tumor growth remarkably in rats compared with laparotomy, a new combined treatment with by-pass operation, irradiation and immunochemotherapy was investigated in 39 advanced thoracic esophageal cancer patients. At by-pass operation, abdominal esophagus was divided and its proximal stump was closed immediately. Cervical esophagus was then divided and its distal stump was pulled out to the right supraclavicular region to make outer fistula. Thus, anticancer drug was poured into the esophagus through outer fistula very easily just before irradiation and then irradiation was performed under the condition that the lesion was immersed in the drugs. As anticancer agent, Mitomycin-C, 5-Fluorouracil or Bleomycin was given alternately. Lately, the combination of 5-Fluorouracil and Vitamin A was preferably used. The changes of immunological parameters and the survival after the onset of treatment was reported.

Abstract: Long-term adjuvant immunochemotherapy carried out on the gastrectomized patients with stomach cancer was reported. The protocol comprises the administration of large-dose of Mitomycin-C (20+10) mg just after gastrectomy and the long-term administration of PSK, FT-207 or (PSK+FT-207). Almost no side effects were observed. According to the studies on the immunological parameters, the increased reactions in PPD skin test and lymphocyte blastogenesis induced by PHA and PWM were observed remarkably in group (P+F) 3 or 6 months after gastrectomy. As for the survival rate, group (P+F) showed the most preferable results at one year in stage IV, at two years in stage III and at three years in all the stages, respectively after gastrectomy.

Abstract: The combined effects of moderate local hyperthermia, bleomycin and ethanol were investigated with Lewis lung carcinoma tumors in female C57BL/6 mice. Different combinations of treatments were performed on days 4 and 7 after tumor implantation. Combined treatment of 41C hyperthermia and bleomycin resulted in mild reductions of tumor growth. Hyperthermia plus bleomycin led to marked reduction in tumor growth under the condition of a 43C temperature. The antitumor effects of 41C hyperthermia combined with bleomycin were enhanced by the additional use of ethanol, and these effects were more remarkable than those of 43C hyperthermia and bleomycin. A possible application of these findings to clinical therapy for advanced esophageal cancer was discussed.