Kozu Yoshiki, Sato Hiroshi, Tsubosa Yasuhiro, Ogawa Hirofumi, Yasui Hirofumi, Kondo Haruhiko
Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
J Cardiothorac Surg. 2011 Oct 12;6:135. doi: 10.1186/1749-8090-6-135.
Surgical treatment for pulmonary metastases is known to be a safe and potentially curative procedure for various primary malignancies. However, there are few reports regarding the prognostic role of surgical treatment for pulmonary metastases from esophageal carcinoma, especially after definitive chemoradiotherapy (CRT).
We retrospectively reviewed 5 patients who underwent surgical treatment for pulmonary metastases from esophageal carcinoma at our institution. The primary treatment for esophageal carcinoma was definitive CRT, and a complete response (CR) was achieved in all patients.
The surgical procedure for pulmonary metastases was wedge resection, and pathological complete resection was achieved in all 5 patients. The disease free interval after definitive CRT varied from 7 to 36 months, with a median of 19 months. There were no perioperative complications, but postoperative respiratory failure occurred in 1 patient. The postoperative hospital stay varied from 4 to 7 days, with a median of 6 days. Three patients are now alive with a good performance status (PS) and are disease free. The other 2 patients died of primary disease. The overall survival after surgical treatment varied from 20 to 90 months, with a median of 29 months.
Surgical treatment should be considered for patients with pulmonary metastases from esophageal carcinoma who previously received CRT and achieved a CR, because it provides not only a longer survival, but also a good postoperative PS for some patients.
对于各种原发性恶性肿瘤，肺转移瘤的外科治疗是一种安全且可能治愈的方法。然而，关于食管癌肺转移瘤外科治疗的预后作用的报道较少，尤其是在接受根治性放化疗（CRT）之后。
我们回顾性分析了在我院接受食管癌肺转移瘤手术治疗的5例患者。食管癌的初始治疗为根治性CRT，所有患者均获得完全缓解（CR）。
肺转移瘤的手术方式为楔形切除术，5例患者均实现了病理完全切除。根治性CRT后的无病间期为7至36个月，中位时间为19个月。围手术期无并发症，但1例患者术后发生呼吸衰竭。术后住院时间为4至7天，中位时间为6天。3例患者目前存活，身体状况良好（PS）且无疾病。另外2例患者死于原发性疾病。手术治疗后的总生存期为20至90个月，中位时间为29个月。
对于先前接受CRT并获得CR的食管癌肺转移患者，应考虑手术治疗，因为它不仅能延长生存期，还能使部分患者术后PS良好。
