Ozawa Yohei, Kamei Takashi, Nakano Toru, Taniyama Yusuke, Miyagi Shigehito, Ohuchi Noriaki
Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
World J Surg. 2016 Jul;40(7):1663-71. doi: 10.1007/s00268-016-3454-9.
This study aimed to evaluate the recurrence rates, timings, locations, and risk factors, and survival in patients with lymph node-negative superficial esophageal squamous cell carcinomas (ESCCs).
We investigated 167 patients with pathological T1 thoracic ESCC who underwent curative esophagectomy with lymphadenectomy between 1986 and 2013. They were classified into lymph node-negative and lymph node-positive groups, each of which included 15 relapsed patients. The recurrence rates, timings, locations, and risk factors, and survival were examined retrospectively.
Significantly better recurrence (12.4 %) and the 5-year overall survival (85.7 %) rates were seen in patients with node-negative superficial ESCC compared with those with node-positive superficial ESCC. Relapsed patients with node-negative superficial ESCC showed a 5-month delay in the time to recurrence compared with relapsed patients with node-positive superficial ESCC, but the recurrence locations were similar. Upper thoracic tumors and the presence of lymph node metastases were independent risk factors for recurrence in superficial ESCC patients, but we did not determine any risk factors in patients who were node negative only. The 5-year overall survival rates did not differ between relapsed node-negative and node-positive patients. Furthermore, the mean times to death and the survival rates from recurrence to death were similar in the node-negative (20.3 months and 9.3 %, respectively) and in the node-positive patients (19.1 months and 13.6 %, respectively) who had relapsed.
Node-negative and node-positive superficial ESCC patients should be followed up similarly, because when recurrences occur, the prognoses and the times to death are similar in node-negative and node-positive superficial ESCC patients.
本研究旨在评估淋巴结阴性的浅表食管鳞状细胞癌（ESCC）患者的复发率、复发时间、复发部位、危险因素及生存率。
我们调查了1986年至2013年间接受根治性食管切除术及淋巴结清扫术的167例病理T1期胸段ESCC患者。他们被分为淋巴结阴性组和淋巴结阳性组，每组各有15例复发患者。对复发率、复发时间、复发部位、危险因素及生存率进行回顾性分析。
与淋巴结阳性的浅表ESCC患者相比，淋巴结阴性的浅表ESCC患者的复发率（12.4%）和5年总生存率（85.7%）明显更好。淋巴结阴性的浅表ESCC复发患者的复发时间比淋巴结阳性的浅表ESCC复发患者延迟5个月，但复发部位相似。胸段上段肿瘤和淋巴结转移的存在是浅表ESCC患者复发的独立危险因素，但我们未确定仅淋巴结阴性患者的任何危险因素。复发的淋巴结阴性和阳性患者的5年总生存率无差异。此外，复发的淋巴结阴性患者（分别为20.3个月和9.3%）和淋巴结阳性患者（分别为19.1个月和13.6%）的平均死亡时间及复发至死亡的生存率相似。
淋巴结阴性和阳性的浅表ESCC患者应进行相似的随访，因为复发时，淋巴结阴性和阳性的浅表ESCC患者的预后及死亡时间相似。
