内镜黏膜下剥离术后追加手术切除治疗早期食管癌的疗效
Efficacy of Additional Surgical Resection After Endoscopic Submucosal Dissection for Superficial Esophageal Cancer.
作者信息
Kudou Michihiro, Shiozaki Atsushi, Fujiwara Hitoshi, Konishi Hirotaka, Shoda Katsutoshi, Arita Tomohiro, Kosuga Toshiyuki, Morimura Ryo, Murayama Yasutoshi, Kuriu Yoshiaki, Ikoma Hisashi, Kubota Takeshi, Nakanishi Masayoshi, Okamoto Kazuma, Dohi Osamu, Konishi Hideyuki, Naito Yuji, Otsuji Eigo
机构信息
Division of Digestive Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Division of Digestive Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
出版信息
Anticancer Res. 2017 Sep;37(9):5301-5307. doi: 10.21873/anticanres.11956.
BACKGROUND/AIM: This study aimed to investigate the efficacy of additional surgical resection (ASR) after endoscopic submucosal dissection (ESD) for superficial esophageal cancer (SEC).
PATIENTS AND METHODS
Clinicopathological features and prognoses were analyzed in esophageal cancer (EC) cases with the indication for additional treatments (AT) after ESD (37 cases) and in cases that underwent primary resection (13 cases).
RESULTS
Sixteen out of 37 cases underwent ASR. The remaining 21 cases underwent other treatments or observation. Although all ASR cases are alive without recurrence, recurrence developed in 2 non-ASR cases. Residual tumors were detected in 2 ASR cases. All 4 cases were T1b and positive for lymph vessel invasion (ly+). No significant difference was observed in surgical outcomes between ASR and primary surgical resection (PSR) cases.
CONCLUSION
AT need to be considered for T1b and ly+ cases, and ASR is one of the effective AT. The safety of ASR was similar to PSR for SEC.
背景/目的：本研究旨在探讨内镜黏膜下剥离术（ESD）后追加手术切除（ASR）治疗早期食管癌（SEC）的疗效。
患者与方法
分析ESD后有追加治疗指征的食管癌（EC）患者（37例）以及接受初次切除的患者（13例）的临床病理特征和预后。
结果
37例患者中有16例行ASR。其余21例接受了其他治疗或观察。尽管所有行ASR的患者均存活且无复发，但2例未行ASR的患者出现了复发。2例行ASR的患者检测到残留肿瘤。所有4例均为T1b且淋巴管浸润阳性（ly+）。ASR与初次手术切除（PSR）病例的手术结果无显著差异。
结论
对于T1b和ly+病例，需要考虑追加治疗，ASR是有效的追加治疗方法之一。ASR对SEC的安全性与PSR相似。
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