Toh Yasushi, Ohga Takefumi, Itoh Shuhei, Kabashima Akira, Yamamoto Kazuharu, Adachi Eisuke, Sakaguchi Yoshihisa, Okamura Takeshi, Hirata Hideki
Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Anticancer Res. 2006 May-Jun;26(3B):2487-91.
A radical esophagectomy with extensive lymph node dissection is the mainstay treatment for submucosal esophageal cancer, though definitive chemoradiotherapy (CRT) has also been applied. However, the treatment outcomes have not yet been extensively investigated.
Forty-nine patients with submucocal esophageal squamous cell carcinoma, 24 and 25 of whom had been treated by a radical esophagectomy with extensive lymph node dissection (Surgery group) and definitive CRT using 5-Fluorouracil and CDDP with concurrent radiation of 60 Gy (CRT group), respectively, formed the study cohort.
In the Surgery group, the overall and cause-specific 5-year survival rates were 75.4% and 90.0%, respectively. No operative or hospital deaths had occurred. In the CRT group, a complete response (CR) had been achieved in 22 (88%) patients. The 3- and 5-year overall survival rates were 79.3% and 36.9%, respectively, while the cause-specific 3- and 5-year survival rates were 75.2% and 55. 7%, respectively. No treatment-related deaths had occurred.
These data suggest that: (i) a radical esophagectomy with extensive lymph node dissection can be a standard treatment offering excellent survival and (ii) a definitive CRT is a reasonable alternative to surgery, especially for patients with complications.
广泛淋巴结清扫的根治性食管切除术是黏膜下食管癌的主要治疗方法，不过也已应用了根治性放化疗（CRT）。然而，治疗效果尚未得到广泛研究。
49例黏膜下食管鳞状细胞癌患者组成了研究队列，其中24例和25例患者分别接受了广泛淋巴结清扫的根治性食管切除术（手术组）和使用5-氟尿嘧啶和顺铂并同步放疗60 Gy的根治性CRT（CRT组）。
手术组的5年总生存率和病因特异性生存率分别为75.4%和90.0%。未发生手术或医院死亡。在CRT组中，22例（88%）患者实现了完全缓解（CR）。3年和5年总生存率分别为79.3%和36.9%，而病因特异性3年和5年生存率分别为75.2%和55.7%。未发生与治疗相关的死亡。
这些数据表明：（i）广泛淋巴结清扫的根治性食管切除术可以作为提供良好生存率的标准治疗方法；（ii）根治性CRT是手术的合理替代方案，特别是对于有并发症的患者。
