Shao L F, Gao Z G, Yang N P, Wei G Q, Wang Y D, Cheng C P
Department of Thoracic Surgery, Henan Cancer Institute & Hospital, Zhengzhou, Henan Province, People's Republic of China.
J Surg Oncol. 1989 Nov;42(3):170-4. doi: 10.1002/jso.2930420308.
Six thousand one hundred twenty-three cases of carcinoma of the esophagus and gastric cardia were treated surgically from 1965 to 1985. Overall resectability was 89.9%. Postoperative mortality was 3%, and incidence of postoperative complication, 10.3%. Follow-up rate was 91.3%, with 5 year survival of 36.8% (esophageal nearly twice that of gastric cardia), and 10 year survival of 17.2%. Factors affecting long-term survival were clinicopathologic staging and preoperative irradiation. Early discovery and timely treatment are the key to high resectability and improved long-term survival. More efficacious combined therapies are needed for the predominant late cases. We propose more radical resection because of the multifocal tendency of esophageal and extensive submucosal infiltration of cardia carcinoma. Continuing refinements of surgical technique helped to reduce postoperative leakage and structure.
1965年至1985年期间，共对6123例食管癌和贲门癌患者实施了手术治疗。总体可切除率为89.9%。术后死亡率为3%，术后并发症发生率为10.3%。随访率为91.3%，5年生存率为36.8%（食管癌的5年生存率几乎是贲门癌的两倍），10年生存率为17.2%。影响长期生存的因素为临床病理分期和术前放疗。早期发现并及时治疗是提高可切除率和改善长期生存的关键。对于占主导地位的晚期病例，需要更有效的联合治疗方法。鉴于食管癌的多灶性倾向和贲门癌广泛的黏膜下浸润，我们建议实施更根治性的切除术。手术技术的不断改进有助于减少术后渗漏和并发症。
