WHILE surgery has made extraordinary advances on several fronts during the last decade, one of the most significant is the trans-thoracic attack on lesions of the esophagus and gastric cardia. Thus by the expedient of a new approach, one of the greatest needs in surgical treatment of malignant disease has been fulfilled.
In order to appreciate this, it is only necessary to refer to the vital statistics of the United States.1 In the year 1945 there were 3,100 deaths from cancer of the esophagus while deaths from carcinoma of the stomach numbered 25,832. If it was true then as now that an estimated 10 per cent of all cancers of the stomach occurred in or involved the cardia, there were 2,583 cases of carcinoma of this region. Thus, if to the 3,100 carcinomas of the esophagus are added 2,583 carcinomas of the cardia, there were in 1945 a total