[Twenty-five years of progress in the treatment of esophageal and gastric cancers].

As we approach the year 2000, it seems useful to look back at the progress that has been made in medicine. The author has had 25 years' experience in gastrointestinal surgery for esophageal and gastric cancers. Twenty-five years ago in the field of gastrointestinal cancer diagnosis, double-contrast radiography was the leading technology and the development of fiberscopes led to an increasing number of early cancers being detected by endoscopy combined with biopsy. The treatment of advanced cancers relied heavily on the surgical knife, with the aim of complete removal of cancer cells by through and extended combined resection. Today, greater importance is placed on limited resection that allows for the preservation of function. The combined use of chemotherapy and radiotherapy is also regarded as important in some areas, reflecting a great change in therapeutic trends. This paper examines the author's 25 years of experience as a clinical surgeon, and, in doing so, provides an outline of the changes in the treatment of esophageal and gastric cancers during the last quarter of this century. Based on this, and with a view to the 21st century, the author hopes to contribute to new developments in the treatment of esophageal and gastric cancers.