Hirai T, Yamashita Y, Mukaida H, Kawano K, Toge T, Niimoto M, Hattori T
Department of Surgery, Hiroshima University, Japan.
Jpn J Surg. 1989 Mar;19(2):182-8. doi: 10.1007/BF02471583.
From 1973 to 1987, 235 patients with esophageal squamous cell carcinoma were treated at Hiroshima University. Of these patients, 121 (51.5 per cent) were submitted to esophagectomy, 93 (39.6 per cent) to bypass surgery and 21 (8.9 per cent) to either exploratory or no surgery. In this report, the 93 cases who underwent bypass surgery were analysed. Ten patients died within thirty days after their operation (10.8 per cent) and there were 33 cases of hospital death (35.5 per cent). Following the bypass surgery, 49 (59.0 per cent) cases were able to tolerate over 50 per cent of their normal oral intake and 22 cases (26.5 per cent) were able to tolerate between 25 per cent and 50 per cent. For twelve cases (14.6 per cent), however, oral ingestion proved impossible up until the time of death due to such complications as leakage. The overall survival rates were 44.3 per cent at 6 months, 12.7 per cent at 1 year and 2.8 per cent at 5 years, respectively. Two cases survived for over 5 years. Hyperthermia was applied in combination with chemotherapy from 1981, however, no case survived for over one year without radiation therapy. Recently, radiation plus hyperthermia is being performed in combination with immunochemotherapy.
1973年至1987年期间，广岛大学共治疗了235例食管鳞状细胞癌患者。其中，121例（51.5%）接受了食管切除术，93例（39.6%）接受了旁路手术，21例（8.9%）接受了探查手术或未进行手术。在本报告中，对接受旁路手术的93例病例进行了分析。10例患者在术后30天内死亡（10.8%），医院死亡病例有33例（35.5%）。旁路手术后，49例（59.0%）患者能够耐受超过正常口服摄入量的50%，22例（26.5%）患者能够耐受25%至50%的摄入量。然而，有12例（14.6%）患者因渗漏等并发症直至死亡都无法经口摄入。总体生存率分别为6个月时44.3%、1年时12.7%、5年时2.8%。有2例患者存活超过5年。自1981年起采用热疗联合化疗，但没有病例在未接受放射治疗的情况下存活超过1年。最近，正在进行放射加 热疗联合免疫化疗。
