Takebayashi Katsushi, Tsubosa Yasuhiro, Matsuda Satoru, Kawamorita Keisuke, Niihara Masahiro, Tsushima Takahiro, Yokota Tomoya, Sato Hiroshi, Onozawa Yusuke, Ogawa Hirofumi, Kamijo Tomoyuki, Onitsuka Tetsuro, Nakagawa Masahiro, Yasui Hirofumi
Divisions of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho Sunto-gun, Shizuoka, Japan
Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho Sunto-gun, Shizuoka, Japan.
Dis Esophagus. 2017 Feb 1;30(2):1-5. doi: 10.1111/dote.12502.
Esophagectomy and definitive chemoradiotherapy are recognized standard initial treatment modalities for cervical esophageal cancer. The goal of this study was to compare the treatment outcomes of curative surgery with those of chemoradiotherapy in patients who had potentially resectable tumor and who were candidates for surgery. We evaluated the data from 49 consecutive patients who were diagnosed with potentially resectable cervical esophageal cancer and who were deemed candidates for surgery. Thirteen patients were included in the surgery group, and 36 patients were included in chemoradiotherapy group. Baseline characteristics were balanced between the two groups. In the chemoradiotherapy group, the complete response rate was 58.3%. There was no significant difference in 5-year overall survival when comparing the surgery group and the chemoradiotherapy group (surgery, 60.6%; chemoradiotherapy, 51.4%; P = 0.89). In the chemoradiotherapy group, of the 15 patients who failed to respond to initial treatment, 11 patients subsequently underwent salvage surgery. In conclusion, curative surgery and chemoradiotherapy as initial treatment for cervical esophageal cancer have comparable survival outcomes. Chemoradiotherapy should be selected as the initial larynx-preserving treatment for patients with cervical esophageal cancer although chemoradiotherapy non-responders require additional treatment, including salvage surgery.
食管切除术和根治性放化疗是公认的颈段食管癌标准初始治疗方式。本研究的目的是比较手术切除与放化疗对潜在可切除肿瘤且适合手术的患者的治疗效果。我们评估了49例连续诊断为潜在可切除颈段食管癌且被认为适合手术的患者的数据。手术组纳入13例患者，放化疗组纳入36例患者。两组间基线特征均衡。在放化疗组中，完全缓解率为58.3%。比较手术组和放化疗组的5年总生存率，差异无统计学意义（手术组为60.6%；放化疗组为51.4%；P = 0.89）。在放化疗组中，15例初始治疗无反应的患者中，有11例随后接受了挽救性手术。总之，手术切除和放化疗作为颈段食管癌的初始治疗，生存结果相当。对于颈段食管癌患者，应选择放化疗作为初始保喉治疗，尽管放化疗无反应者需要额外治疗，包括挽救性手术。
