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颈段食管癌的临床病理特征:63例连续接受手术切除患者的回顾性分析

Clinicopathological Features of Cervical Esophageal Cancer: Retrospective Analysis of 63 Consecutive Patients Who Underwent Surgical Resection.

作者信息

Saeki Hiroshi, Tsutsumi Satoshi, Yukaya Takafumi, Tajiri Hirotada, Tsutsumi Ryosuke, Nishimura Sho, Nakaji Yu, Kudou Kensuke, Akiyama Shingo, Kasagi Yuta, Nakashima Yuichiro, Sugiyama Masahiko, Sonoda Hideto, Ohgaki Kippei, Oki Eiji, Yasumatsu Ryuji, Nakashima Torahiko, Morita Masaru, Maehara Yoshihiko

机构信息

*Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan †Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ‡Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan.

出版信息

Ann Surg. 2017 Jan;265(1):130-136. doi: 10.1097/SLA.0000000000001599.

Abstract

OBJECTIVE

The objectives of this retrospective study were to elucidate the clinicopathological features and recent surgical results of cervical esophageal cancer.

SUMMARY BACKGROUND DATA

Cervical esophageal cancer has been reported to have a dismal prognosis. Accurate knowledge of the clinical characteristics of cervical esophageal cancer is warranted to establish appropriate therapeutic strategies.

METHODS

The clinicopathological features and treatment results of 63 consecutive patients with cervical esophageal cancer (Ce group) who underwent surgical resection from 1980 to 2013 were analyzed and compared with 977 patients with thoracic or abdominal esophageal cancer (T/A group) who underwent surgical resection during that time.

RESULTS

Among the patients who received curative resection, the 5-year overall and disease-specific survival rates of the Ce patients were significantly better than those of the T/A patients (overall: 77.3% vs 46.5%, respectively, P = 0.0067; disease-specific: 81.9% vs 55.8%, respectively, P = 0.0135). Although total pharyngo-laryngo-esophagectomy procedures were less frequently performed in the recent period, the rate of curative surgical procedures was markedly higher in the recent period (2000-1013) than that in the early period (1980-1999) (44.4% vs 88.9%, P = 0.0001). The 5-year overall survival rate in the recent period (71.5%) was significantly better than that in the early period (40.7%, P = 0.0342).

CONCLUSIONS

Curative resection for cervical esophageal cancer contributes to favorable outcomes compared with other esophageal cancers. Recent surgical results for cervical esophageal cancer have improved, and include an increased rate of curative resection and decreased rate of extensive surgery.

摘要

目的

本回顾性研究的目的是阐明颈段食管癌的临床病理特征及近期手术结果。

总结背景资料

据报道,颈段食管癌预后不佳。有必要准确了解颈段食管癌的临床特征,以制定合适的治疗策略。

方法

分析了1980年至2013年连续接受手术切除的63例颈段食管癌患者(Ce组)的临床病理特征和治疗结果,并与同期接受手术切除的977例胸段或腹段食管癌患者(T/A组)进行比较。

结果

在接受根治性切除的患者中,Ce组患者的5年总生存率和疾病特异性生存率显著高于T/A组患者(总生存率:分别为77.3%和46.5%,P = 0.0067;疾病特异性生存率:分别为81.9%和55.8%,P = 0.0135)。尽管近期全下咽-喉-食管切除术的实施频率较低,但近期(2000 - 2013年)根治性手术的比例明显高于早期(1980 - 1999年)(44.4%对88.9%,P = 0.0001)。近期的5年总生存率(71.5%)显著高于早期(40.7%,P = 0.0342)。

结论

与其他食管癌相比,颈段食管癌的根治性切除有助于取得良好的治疗效果。颈段食管癌的近期手术结果有所改善,包括根治性切除率增加和广泛手术率降低。

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