Rapid Growth of Untreated Esophageal Squamous-Cell Carcinoma in 10 Patients

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Abstract
We documented the natural history of esophageal carcioma and its rapid growth by measuring the change in mor diameter radiographically in 10 patients during an bservation period because the diagnosis had been issed. Nine men and one woman (age range, 48–74 ears; mean, 60 years) were included in the study. Eight atients had undergone esophagography for gastrointesnal complaints and had lesions missed on the initial terpretation that were apparent on retrospective review fter the patient had returned with more severe comlaints and undergone repeat studies; two patients had efused treatment. The tumor was squamous-cell carcioma in all. The treatment-free retrospective observation eriod ranged from 4 to 19 months (mean, 12.2 months) nd was shorter for elevated (mean, 9.2 months) than for epressed lesions (mean. 16.8 months). The longitudinal iameter increased from 10–100 mm initially (mean, 0.5 mm) to 32–150 mm (mean, 74.9 mm). No correlation xisted between the increase in size and histologic feares. This documentation of the rapid increase in the size f esophageal carcinoma involving at least the submucosa onfirms clinical impressions of the aggressive nature of is lesion and offers an explanation of why this disease is eldom detected at an early stage and long-term survival so poor after the early stage of disease.

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