下胸段食管癌鳞癌患者是否需要行上纵隔淋巴结清扫术？
Is upper mediastinal lymphadenectomy necessary in squamous carcinoma of the lower thoracic oesophagus?
作者信息
Tabira Y, Lida S, Ichimaru T, Sakaguchi T, Nakano K, Nagamoto N, Tanaka M, Yasunaga M, Kitamura N
机构信息
First Department of Surgery, Kumamoto University School of Medicine, Japan.
出版信息
Int Surg. 2000 Oct-Dec;85(4):277-80.
AIM
We examined the indication of upper mediastinal lymphadenectomy for a squamous cell carcinoma of the lower thoracic oesophagus.
METHODS
49 patients underwent a curative oesophagectomy with upper mediastinal lymphadenectomy for a squamous cell carcinoma of the lower thoracic oesophagus. Node status and clinicopathological characteristics of these patients were reviewed retrospectively.
RESULTS
16 (94.1%) of 17 patients with superficial tumours had no positive node in the upper mediastinum. Nine (29.0%) of 31 patients with transmural tumours had positive nodes in the upper mediastinum (P = 0.04). Ten (20.4%) of 49 patients had many positive nodes in the upper mediastinum. Of these 10 patients, 6 patients had 5 or more positive nodes in all. The 5-year survival rate for patients with 5 or more positive nodes was 7.7%, which was significantly poorer than patients with 4 or fewer positive nodes.
CONCLUSIONS
Upper mediastinal lymphadenectomy is unnecessary in most of the superficial squamous carcinomas of the lower thoracic oesophagus.
目的
我们研究了胸段下段食管鳞状细胞癌行上纵隔淋巴结清扫术的指征。
方法
49例胸段下段食管鳞状细胞癌患者接受了根治性食管切除术并进行了上纵隔淋巴结清扫术。回顾性分析这些患者的淋巴结状态及临床病理特征。
结果
17例浅表肿瘤患者中有16例（94.1%）上纵隔无阳性淋巴结。31例穿透性肿瘤患者中有9例（29.0%）上纵隔有阳性淋巴结（P = 0.04）。49例患者中有10例（20.4%）上纵隔有多个阳性淋巴结。在这10例患者中，6例患者共有5个或更多阳性淋巴结。5个或更多阳性淋巴结患者的5年生存率为7.7%，明显低于4个或更少阳性淋巴结的患者。
结论
大多数胸段下段食管浅表鳞状细胞癌无需行上纵隔淋巴结清扫术。
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