Department of Surgery, Kurume University School of Medicine, Kurume University Hospital, Kurume-shi, Fukuoka, Japan.
Dis Esophagus. 2010 Nov;23(8):646-51. doi: 10.1111/j.1442-2050.2010.01069.x.
Esophageal cancer patients with distant organ metastasis have usually been treated only to palliate symptoms without multimodality therapy. The current study evaluates the role of multimodality therapy in esophageal squamous cell cancer patients with distant organ metastasis. Between February 1988 and January 2007, 80 esophageal squamous cell cancer patients with distant organ metastases were treated at our institution. Multimodality therapy was performed in 58 patients: 43 patients received chemoradiotherapy, 13 underwent surgery followed by chemotherapy and/or radiation therapy, and two received chemotherapy or chemoradiotherapy followed by surgery. Thirteen patients received single-modality therapy; chemotherapy, radiotherapy, or surgery alone. The remaining nine patients received best supportive care alone. The metastatic organ was the liver (n= 40), the lungs (n= 33), bone (n= 10), and other (n= 6). Nine patients had metastasis in two organs. There was no difference in the median survival among the sites of organ metastasis, lung, liver, or bone (P= 0.8786). The survival of patients treated with multimodality therapy was significantly better than that of the patients who received single-modality therapy or best supportive care alone (P < 0.0001). In patients treated with multimodallity therapy, there was no difference in survival for patients treated with surgery compared with patients treated without surgery (P= 0.1291). This retrospective study involves an inevitable issue of patient selection bias. However, these results suggested that multimodality therapy could improve survival of the esophageal squamous cell cancer patients with distant organ metastasis.
对于发生远处器官转移的食管癌患者，目前通常只采用姑息疗法，而不采用多模式治疗。本研究旨在评估多模式治疗对发生远处器官转移的食管鳞癌患者的作用。1988 年 2 月至 2007 年 1 月，80 例发生远处器官转移的食管鳞癌患者在我院接受治疗。58 例患者采用多模式治疗：43 例患者接受放化疗，13 例患者先接受手术，然后接受化疗和/或放疗，2 例患者先接受化疗或放化疗，然后接受手术。13 例患者接受单一模式治疗：单独化疗、放疗或手术。其余 9 例患者只接受最佳支持治疗。转移器官为肝脏（n=40）、肺（n=33）、骨（n=10）和其他（n=6）。9 例患者有 2 个器官转移。器官转移部位（肺、肝或骨）对中位生存期无影响（P=0.8786）。多模式治疗组患者的生存情况明显好于单一模式治疗组或仅接受最佳支持治疗组（P<0.0001）。在接受多模式治疗的患者中，手术治疗与未手术治疗患者的生存情况无差异（P=0.1291）。本回顾性研究涉及患者选择偏倚的不可避免问题。然而，这些结果表明，多模式治疗可以提高发生远处器官转移的食管鳞癌患者的生存。
