THE ARTICLE by DeBakey and Cooley entitled "The Combined Right Thoracic and Abdominal Approach for Carcinoma of the Esophagus with Particular Reference to Palliative Resection," beginning on page 781 of the current issue, is a provocative one and is deserving of careful study. Cancer of the esophagus is not an esoteric subject, since it constitutes about 2% of all malignant growths, and when considered in conjunction with adenocarinoma of the gastric cardia comprises about 10% of all cases of cancer of the gastrointestinal tract. In general, cancer of the esophagus has its peak incidence in persons in their early 60's; therefore it is likely to increase steadily in frequency as the life expectancy of our population is lengthened.
Present-day experience with the therapy of this disease is admittedly discouraging. Patients do not readily consult a physician when afflicted with minor disturbances in the swallowing function. Furthermore, dysphagia may be absent