Salama F D, Leong Y P
J R Coll Surg Edinb. 1989 Apr;34(2):97-100.
One hundred and seventy-one patients with oesophageal carcinoma were seen in the 7-year period October 1976 to September 1983. One hundred and thirty-three cases (77.8%) were explored with a view to curative resection. This was accomplished in 98 cases (73.6% of explored patients, 57.3% of the entire group). Overall operative mortality was 10.2%. Of patients undergoing curative resection, 9% developed benign strictures which responded to 1-4 dilatations, while 14.8% developed local recurrence which marked the terminal event. After excluding operative deaths, 61.3% of patients survived for 1 year, 27% for 3 years and 17.3% for 5 years. Five-year survival for patients with squamous carcinoma was 36% while that for adenocarcinoma patients was only 3%. It is concluded that curative resection can be accomplished in a selected group of patients dealt with in a specialized unit with low operative mortality. This approach offers the patient good palliation and the best chance of prolonged survival.
在1976年10月至1983年9月的7年期间,共诊治了171例食管癌患者。其中133例(77.8%)接受了旨在根治性切除的探查。98例(占探查患者的73.6%,占整个组的57.3%)完成了根治性切除。总体手术死亡率为10.2%。接受根治性切除的患者中,9%出现良性狭窄,经1 - 4次扩张后缓解,而14.8%出现局部复发,这成为最终结局。排除手术死亡病例后,61.3%的患者存活1年,27%存活3年,17.3%存活5年。鳞状细胞癌患者的5年生存率为36%,而腺癌患者仅为3%。结论是,在专门单位对选定的患者群体进行治疗,可实现根治性切除,且手术死亡率低。这种方法能为患者提供良好的姑息治疗以及延长生存期的最佳机会。