Siewert J R, Stein H J
Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München.
Kongressbd Dtsch Ges Chir Kongr. 2001;118:44-9.
Compared to adenocarcinoma of the esophagus (Barrett cancer) the prevalence of esophageal squamous cell cancer is decreasing. Patients with squamous cell cancer have a less favorable risk profile for surgical therapy, a higher prevalence of lymphatic spread in early tumor stages, and more frequently an invasion of lymphatic vessels (lymphangiosis carcinomatosa) than patients with adenocarcinoma. A transthoracic en-bloc esophagectomy is therefore the procedure of choice for squamous cell esophageal cancer. The prognosis after surgical resection is worse for squamous cell esophageal cancer as compared to adenocarcinoma. In patients with early Barrett cancer a limited surgical approach is possible. The results of radical transmediastinal esophagectomy compare favorably to transthoracic esophagectomy in patients with locoregional Barrett cancer.
与食管腺癌（巴雷特癌）相比，食管鳞状细胞癌的发病率正在下降。鳞状细胞癌患者接受手术治疗的风险状况较差，在肿瘤早期淋巴转移的发生率较高，且与腺癌患者相比，淋巴管受侵（癌性淋巴管炎）更为常见。因此，经胸整块食管切除术是食管鳞状细胞癌的首选手术方式。与腺癌相比，食管鳞状细胞癌手术切除后的预后更差。对于早期巴雷特癌患者，可以采用有限的手术方法。在局部区域性巴雷特癌患者中，根治性经纵隔食管切除术的效果优于经胸食管切除术。
