Kato H, Tachimori Y, Watanabe H, Yamaguchi H, Ishikawa T, Itabashi M
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Cancer. 1990 Dec 1;66(11):2319-23. doi: 10.1002/1097-0142(19901201)66:11<2319::aid-cncr2820661111>3.0.co;2-1.
We report 92 patients treated with esophagectomy for superficial esophageal carcinoma (SEC; 9.1% of all resected esophageal cancers at our institution). The operative mortality rate was 5.4%. In 24 cases, cancer invasion was limited to the mucosa, and in 68 to the submucosa. Twenty-three patients in the former group had no lymph node involvement, whereas 24 patients (35.3%) of the latter group had lymph node metastases. The 5-year survival rate after surgery for patients with SEC limited to the mucosa was 83.5%, which was significantly better than that for carcinoma invading the submucosa (54.9%). No recurrent disease occurred in patients with lesions limited to the mucosa. In conclusion, an esophagectomy with wide lymphadenectomy is necessary to provide a better prognosis for SEC invading the submucosa, whereas a less extensive treatment may be considered for SEC limited to the mucosa.
我们报告了92例接受食管癌切除术治疗的浅表食管癌患者（占我院所有切除食管癌的9.1%）。手术死亡率为5.4%。24例患者癌症侵犯限于黏膜层，68例侵犯至黏膜下层。前一组的23例患者无淋巴结受累，而后一组的24例患者（35.3%）有淋巴结转移。黏膜层局限的浅表食管癌患者术后5年生存率为83.5%，显著高于侵犯黏膜下层的癌（54.9%）。病变局限于黏膜层的患者未发生复发性疾病。总之，对于侵犯黏膜下层的浅表食管癌，行广泛淋巴结清扫的食管癌切除术有助于获得更好的预后，而对于局限于黏膜层的浅表食管癌，可考虑采用范围较小的治疗方式。
