Udagawa Harushi, Tsutsumi Kenji, Kinoshita Yoshihiro, Ueno Masaki, Mine Shinji, Ehara Kazuhisa, Kohno Tadasu, Tsurumaru Masahiko
Department of Gastroenterological Surgery Toranomon Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2007 May;108(3):116-9.
A study of 256 patients whose dates and patterns of first mode of recurrence after curative esophagectomy from 1984 to 2004 revealed the recent improvement in survival after the detection of tumor recurrence. This tendency was evident in lymphatic recurrence, particularly in the cervical area. Lung metastasis was another mode of recurrence that has shown recent improvement. In this series, 20 patients with lymph node metastases underwent reoperation for local or regional tumor control. The addition of systemic chemotherapy or chemoradiotherapy was our general rule. The 5-year survival rate after the detection of tumor recurrence in these 20 patients was 47.4%. Six with lung metastases in the group of patients whose esophagectomies were performed in the last 7 years underwent video-assisted pulmonary tumor resection. Five patients in this group are alive without signs of further recurrence for 92 to 1,437 days. The early detection of recurrent tumor, vigorous attempts to achieve locoregional control, and the addition of systemic chemotherapy are all important in achieving better results. We routinely perform conventional cervical and abdominal ultrasonography and computed tomography every 6 months until 6 years after surgery is performed.
一项针对1984年至2004年间接受根治性食管切除术后首次复发日期和模式的256例患者的研究显示,肿瘤复发检测后生存率近期有所改善。这种趋势在淋巴转移复发中很明显,尤其是在颈部区域。肺转移是另一种近期显示出改善的复发模式。在该系列中,20例有淋巴结转移的患者接受了再次手术以进行局部或区域肿瘤控制。一般会加用全身化疗或放化疗。这20例患者肿瘤复发检测后的5年生存率为47.4%。在过去7年接受食管切除术的患者组中,6例有肺转移的患者接受了电视辅助肺肿瘤切除术。该组中有5例患者存活,92至1437天无进一步复发迹象。早期发现复发性肿瘤、积极实现局部区域控制以及加用全身化疗对于取得更好的结果都很重要。我们常规每6个月进行一次传统的颈部和腹部超声检查及计算机断层扫描,直至术后第6年。