Zhang Ming-yue, Wang Zhou, Liu Xiang-yan, Chen Gang, Liu Fan-ying
Department of Thoracic Surgery, Provincial Hospital Affiliated to Shan Dong University, Jinan, China.
Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1048-50.
To investigate the local control of radiotherapy following Ivor-Lewis esophagectomy in the patients with stage IIA middle-third thoracic esophageal cancer.
From June 1999 to June 2002, 125 patients with stage IIA squamous cell carcinoma of the middle-third thoracic esophagus were treated with Ivor-Lewis esophagectomy with two-fields lymphadenectomy. The survival rate was calculated by Kaplan-meier method and the difference of recurrence rate compared by chi(2) test.
The 3-year and 5-year survival rates were 58.4% and 43.2% in this group, respectively. Tumor recurrence occurred in 61 of the 125 patients (48.8%) within 3 years after operation. Of all cases of recurrence, 38 patients (30.4%) developed locoregional recurrence (including 5 patients with locoregional and hematogenous recurrence simultaneously). The locoregional recurrence rate of patients who received postoperative radiotherapy (20.3%) was significantly lower than that of both the group who received adjunctive chemotherapy (40.6%) and the group without adjunctive therapy (41.4%) (P < 0.05).
About half of the patients would develop recurrence disease within 3 years after Ivor-Lewis esophagectomy with two-fields lymph-adenectomy. Radiotherapy following Ivor-Lewis esophagectomy is an effective strategy to control local recurrence of the stage II A middle-third thoracic esophageal cancer.
探讨IIA期胸段食管中段癌患者行Ivor-Lewis食管癌切除术后放疗的局部控制情况。
1999年6月至2002年6月，125例IIA期胸段食管中段鳞状细胞癌患者接受Ivor-Lewis食管癌切除术并双野淋巴结清扫。采用Kaplan-Meier法计算生存率，采用卡方检验比较复发率差异。
该组患者3年和5年生存率分别为58.4%和43.2%。125例患者中有61例（48.8%）在术后3年内出现肿瘤复发。在所有复发病例中，38例（30.4%）发生局部区域复发（包括5例同时发生局部区域和血行转移复发）。接受术后放疗患者的局部区域复发率（20.3%）显著低于接受辅助化疗组（40.6%）和未接受辅助治疗组（41.4%）（P<0.05）。
行Ivor-Lewis食管癌切除术并双野淋巴结清扫术后，约一半患者会在3年内出现复发。Ivor-Lewis食管癌切除术后放疗是控制IIA期胸段食管中段癌局部复发的有效策略。
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