Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Surg Today. 2011 Jul;41(7):966-9. doi: 10.1007/s00595-010-4402-1. Epub 2011 Jul 12.
Metachronous gastric carcinoma arising in a gastric tube used for esophageal reconstruction has been occasionally encountered in long-term survivors of esophageal cancer. This study investigated 10 cases of gastric tube cancer in order to clarify the characteristics and the outcome of these patients.
Four hundred and seventy-one patients underwent a radical esophagectomy at Kyushu University Hospital between 1989 and 2003. There were 10 cases of gastric tube cancer after an esophagectomy.
The interval between the esophagectomy and the development of the gastric tube cancer ranged from 1.1 to 7 years. There was no peak for the incidence of gastric tube cancer. In 6 of 10 cases of gastric tube cancer, endoscopic or surgical resection were performed for the treatment; however, chemotherapy was administered to the other 4 cases for several reasons. The prognosis of patients who underwent resection was better than that of the other patients.
Frequent endoscopic examinations are therefore important even several years after performing an esophagectomy, since the risk of gastric tube cancer is higher than the risk of a recurrence of esophageal cancer several years after an esophagectomy. Only an early diagnosis permits a less invasive and appropriate approach for the treatment of gastric tube cancer.
在食管癌长期生存者中，偶尔会发生在用于食管重建的胃管中出现的胃管癌。本研究调查了 10 例胃管癌患者，旨在阐明这些患者的特征和结局。
1989 年至 2003 年，在九州大学医院进行了 471 例根治性食管切除术。在食管癌根治术后发生了 10 例胃管癌。
食管切除术与胃管癌发生之间的间隔时间为 1.1 至 7 年。胃管癌的发病率没有高峰。在 10 例胃管癌中有 6 例经内镜或手术切除进行治疗；然而，由于多种原因，对其他 4 例患者进行了化疗。接受切除治疗的患者的预后好于其他患者。
因此，即使在进行食管切除术几年后，也需要频繁进行内镜检查，因为胃管癌的风险高于食管切除术几年后食管癌复发的风险。只有早期诊断才能为胃管癌的治疗提供侵袭性较小且合适的方法。
