Saito Hiroshige, Nabeya Yoshihiro, Takiguchi Nobuhiro, Ikeda Atsushi, Kainuma Osamu, Soda Hiroaki, Tonooka Toru, Arimitsu Hidehito, Yanagibashi Hiroo, Kobayashi Ryosuke, Chibana Tomofumi, Ishige Fumitaka, Yamamoto Hiroshi, Hironaka Shuichi, Nagata Matsuo
Dept. of Digestive Surgery, Chiba Cancer Center.
Gan To Kagaku Ryoho. 2015 Sep;42(9):1099-101.
A 78-year-old man presented with a chief complaint of dysphagia. He was diagnosed with an esophageal squamous cell carcinoma and referred to our hospital. A type 3 tumor was identified in the lower thoracic esophagus on endoscopy. A CT scan revealed lymph node metastases at the No. 3 station. The clinical stage of the tumor was T3N1M0, Stage III. The patient was treated with neoadjuvant chemotherapy consisting of2 courses of5 -FU and nedaplatin. He had a partial response and underwent a radical esophagectomy. Histopathological examination revealed a complete response of the primary lesion and viable cancer cells in only one lymph node at the No. 3 station. No adjuvant chemotherapy was administered. Three months after the operation, recurrences in the upper abdominal multiple para-aortic lymph nodes were detected. Although he was treated with chemotherapy, he died 7 months after the operation. Even after a complete response of the primary lesion was achieved using neoadjuvant chemotherapy, esophageal cancer with lymph node metastasis has the potential for an early recurrence. Therefore, we should consider adjuvant therapy in such cases.
一名78岁男性因吞咽困难为主诉前来就诊。他被诊断为食管鳞状细胞癌并转诊至我院。内镜检查发现胸段食管下段有3型肿瘤。CT扫描显示3区有淋巴结转移。肿瘤的临床分期为T3N1M0，Ⅲ期。患者接受了由2个疗程的5-氟尿嘧啶和奈达铂组成的新辅助化疗。他有部分缓解，并接受了根治性食管切除术。组织病理学检查显示原发灶完全缓解，仅3区的一个淋巴结中有存活癌细胞。未给予辅助化疗。术后3个月，检测到上腹部多发主动脉旁淋巴结复发。尽管他接受了化疗，但术后7个月死亡。即使使用新辅助化疗使原发灶完全缓解，有淋巴结转移的食管癌仍有早期复发的可能。因此，对于此类病例我们应考虑辅助治疗。
