Abe S, Tachibana M, Shiraishi M, Nakamura T
Second Department of Surgery, Shimane Medical University, Izumo, Japan.
J Thorac Cardiovasc Surg. 1990 Aug;100(2):287-91.
The prognostic significance of lymph node metastasis was analyzed in 41 patients with locally resectable epidermoid carcinoma of the esophagus. The 5-year survival rate was 50.9% if no metastases or only single node metastasis was present and 29.8% when the lymph node metastasis was confined to one anatomic compartment. All patients with metastasis to two nodes died within 4 years of operation, and all with involvement of three nodes or more died within 3 years. Even with no metastases or single node metastasis, three of 22 patients (13.6%) died of recurrence or metastasis or a combination of the two. Although nodal dissection may be beneficial for selected patients, our results indicate that the survival period is short in the presence of a small number of lymph node metastases, even if the local disease is resectable and despite nodal dissection. Cure is unlikely when cervical or abdominal nodes are involved, and a conservative approach may be indicated for such patients.
对41例局部可切除的食管表皮样癌患者的淋巴结转移的预后意义进行了分析。如果没有转移或仅存在单个淋巴结转移，5年生存率为50.9%；当淋巴结转移局限于一个解剖区域时，5年生存率为29.8%。所有有两个淋巴结转移的患者均在术后4年内死亡，所有有三个或更多淋巴结受累的患者均在3年内死亡。即使没有转移或单个淋巴结转移，22例患者中有3例（13.6%）死于复发或转移或两者兼有。虽然淋巴结清扫术可能对某些患者有益，但我们的结果表明，即使局部疾病可切除且进行了淋巴结清扫术，存在少量淋巴结转移时生存期仍较短。当颈部或腹部淋巴结受累时，治愈的可能性不大，对于此类患者可能需要采取保守治疗方法。
