Gupta N M, Jindal R, Prakash O, Gupta R, Bhasin D K
Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Surg Today. 2001;31(5):400-4. doi: 10.1007/s005950170129.
This retrospective review aimed to assess the clinical profile and outcome of squamous cell carcinoma as compared with adenocarcinoma of the lower third of esophagus and cardia following a transhiatal esophagectomy. A total of 169 patients were analyzed retrospectively in this series from 1989 to 1994. There were 100 patients with squamous cell carcinoma (SCC) and 69 patients with adenocarcinoma (ADC). All tumors were assessed by an esophagogram, upper gastrointestinal endoscopy, and abdominal ultrasonography. The surgical procedure performed in all cases was a transhiatal esophagectomy (THE). The mean age of the patients with SCC and ADC was comparable (48 +/- 14 vs 54 +/- 12 years). Male/female ratio was 1.0:1.4 in the SCC group while in the ADC group it was 8.8:1.0. The main symptom in both the groups was grade II dysphagia (62% in SCC and 60% in ADC). The mean length of the tumor was 6.6 +/- 4.5 cm in the SCC group and 4.2 +/- 3.3 cm in the ADC group. The resectability rate of the SCC group was significantly higher (76%) than in the ADC group (55%). The 6-month and 1-year survival for the SCC patients was not significantly different from the ADC patients (83.7% and 49.3% vs 85.0% and 54.0%). The 5-year survival achieved in SCC was higher than in the ADC group (11.6% vs 7.2%) but the difference was not statistically significant. Adenocarcinoma arising from the distal esophagus and cardia was more common in males, and also occurred in a higher age group and had a lower resectability rate than squamous cell carcinoma. No case of Barrett's esophagus was encountered. The short- and long-term survival in both tumors were similar.
本回顾性研究旨在评估经胸段食管切除术治疗食管下段和贲门部鳞状细胞癌与腺癌的临床特征及预后。本研究回顾性分析了1989年至1994年间的169例患者。其中鳞状细胞癌（SCC）患者100例，腺癌（ADC）患者69例。所有肿瘤均通过食管造影、上消化道内镜检查和腹部超声进行评估。所有病例均采用经胸段食管切除术（THE）。SCC和ADC患者的平均年龄相当（48±14岁 vs 54±12岁）。SCC组男女比例为1.0:1.4，而ADC组为8.8:1.0。两组的主要症状均为Ⅱ级吞咽困难（SCC组为62%，ADC组为60%）。SCC组肿瘤平均长度为6.6±4.5 cm，ADC组为4.2±3.3 cm。SCC组的可切除率显著高于ADC组（76% vs 55%）。SCC患者的6个月和1年生存率与ADC患者无显著差异（83.7%和49.3% vs 85.0%和54.0%）。SCC患者的5年生存率高于ADC组（11.6% vs 7.2%），但差异无统计学意义。远端食管和贲门部腺癌在男性中更为常见，发病年龄也较高，可切除率低于鳞状细胞癌。未发现Barrett食管病例。两种肿瘤的短期和长期生存率相似。
