Kubota K, Kato H, Tachimori Y, Watanabe H, Yamaguchi H, Nakanishi Y, Iinuma G
Department of Surgery, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.
Hepatogastroenterology. 2001 Sep-Oct;48(41):1364-7.
BACKGROUND/AIMS: The long-term prognosis of a recurrent esophageal cancer at the anastomosis after esophagectomy is generally unfavorable. We have experienced six cases in our institute where surgical treatment resulted in a good prognosis.
Between 1962 and 1997, 1720 patients underwent esophagectomy for esophageal cancers in our institute. Anastomotic recurrence was identified in 13 and surgical therapy was performed for six of these. Their clinical and histopathological features were examined with reference to control of anastomotic recurrent esophageal cancers.
The six patients were all males with an average age of 61.5 years. Their median disease-free interval was 5.5 months. Three patients lived more than five years after the first esophagectomy. Histopathologically, regional lymph node metastases were found in four of the cases and cervical lymph node metastases were detected in two at the initial esophagectomy. Vessel invasion was evident in three cases, intraepithelial spread in one, and multiple cancers in two. There were no cases with intramural metastasis. Radiotherapy and/or chemotherapy were added for three cases.
After esophagectomy for esophageal cancers, frequent examination of the anastomotic site using endoscopy and long-term follow-up studies are desirable. The option of surgery should not be ignored when a recurrent cancer appears only at the anastomosis.
背景/目的：食管癌切除术后吻合口复发癌的长期预后通常不佳。我们研究所曾有6例手术治疗后预后良好的病例。
1962年至1997年期间，我们研究所1720例患者因食管癌接受了食管切除术。其中13例被确定为吻合口复发，对其中6例进行了手术治疗。参照吻合口复发食管癌的控制情况，对其临床和组织病理学特征进行了检查。
6例患者均为男性，平均年龄61.5岁。他们的无病间隔时间中位数为5.5个月。3例患者在首次食管切除术后存活超过5年。组织病理学检查发现，4例有区域淋巴结转移，2例在初次食管切除时发现有颈部淋巴结转移。3例有血管侵犯，1例有上皮内扩散，2例有多原发性癌。无壁内转移病例。3例患者加用了放疗和/或化疗。
食管癌切除术后，应定期使用内镜检查吻合口部位并进行长期随访研究。当复发癌仅出现在吻合口时，不应忽视手术治疗的选择。
