Kanamori Jun, Aokage Keiju, Hishida Tomoyuki, Yoshida Junji, Tsuboi Masahiro, Fujita Takeo, Nagino Masato, Daiko Hiroyuki
Division of Esophageal Surgery, National Cancer Center Hospital East , Kashiwa.
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya.
Jpn J Clin Oncol. 2017 Jan;47(1):25-31. doi: 10.1093/jjco/hyw141. Epub 2016 Sep 21.
The purposes of this study were to determine the role of surgical treatment and to identify factors affecting survival of patients undergoing resection of pulmonary metastatic tumors from esophageal carcinoma.
We reviewed 33 patients who had undergone resection of pulmonary metastatic tumors from esophageal carcinoma after definitive treatment.
The operative morbidity rate was only 5%, no patients died within 30 days after resection, and complete resection was achieved in 30 patients. The overall 1-, 3- and 5-year survival rates after pulmonary metastasectomy were 79.4, 47.8 and 43.0%, respectively, and the median survival time was 17.9 months. The factors found on univariate analysis to affect survival significantly were disease-free interval <16 months and nodal involvement of the primary tumor. The most frequent pattern of initial recurrence after pulmonary resection was distant metastasis (70%).
We demonstrated the safety and effectiveness of surgical resection for selected patients with pulmonary metastatic tumors from esophageal carcinoma. However, with a high recurrence rate in patients with negative prognostic factors, adjuvant systemic chemotherapy after pulmonary resection should be considered.
本研究旨在确定手术治疗的作用，并识别影响食管癌肺转移瘤切除患者生存的因素。
我们回顾了33例在确定性治疗后接受食管癌肺转移瘤切除术的患者。
手术发病率仅为5%，无患者在切除术后30天内死亡，30例患者实现了完全切除。肺转移瘤切除术后1年、3年和5年的总生存率分别为79.4%、47.8%和43.0%，中位生存时间为17.9个月。单因素分析发现，影响生存的显著因素为无病间期<16个月和原发肿瘤有淋巴结受累。肺切除术后最常见的初始复发模式是远处转移（70%）。
我们证明了手术切除对部分食管癌肺转移瘤患者的安全性和有效性。然而，对于具有不良预后因素的患者，复发率较高，应考虑肺切除术后辅助全身化疗。
