Motoyama Satoru, Sato Yusuke, Sasaki Tomohiko, Wakita Akiyuki, Kawakita Yuta, Liu Jiajia, Nagaki Yushi, Saito Hajime, Imai Kazuhiro, Konno Hayato, Mizusawa Kaori T, Minamiya Yoshihiro
Esophageal Surgery, Akita University Hospital, Akita, Japan
Esophageal Surgery, Akita University Hospital, Akita, Japan.
Anticancer Res. 2017 Oct;37(10):5837-5843. doi: 10.21873/anticanres.12027.
We investigated the safety of adding Japanese-style extended 3-field lymphadenectomy in patients treated with neoadjuvant chemoradiotherapy (NACRT) for thoracic esophageal squamous cell carcinoma (TESCC). Furthermore, the efficacy of NACRT, as shown by the pathological and metabolic responses were determined.
One hundred consecutive patients with cStage II-IV TESSC were enrolled. We analyzed the adverse events related to NACRT and surgical complications following surgery. Pathological responses to NACRT and the association between pCR and [F]-fluorodeoxyglucose positron-emission tomography (FDG-PET) evaluation were investigated.
Adding Japanese-style extended 3-field lymph node dissection after NACRT did not increase serious surgical complications. Seventy-four percent of patients experienced grade 2-3 pathological response, with 25% achieving pCR. There was a significant relationship between the change from positive to negative findings on FDG-PET/CT and pCR.
Transthoracic esophagectomy with Japanese-style extended 3-field lymph node dissection after NACRT is a safe and powerful treatment.
我们研究了在接受新辅助放化疗（NACRT）的胸段食管鳞状细胞癌（TESCC）患者中增加日式扩大三野淋巴结清扫术的安全性。此外，还确定了NACRT的疗效，以病理和代谢反应来衡量。
连续纳入100例cStage II-IV期TESCC患者。我们分析了与NACRT相关的不良事件以及术后的手术并发症。研究了对NACRT的病理反应以及病理完全缓解（pCR）与[F] - 氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）评估之间的关联。
NACRT后增加日式扩大三野淋巴结清扫术并未增加严重手术并发症。74%的患者出现2-3级病理反应，25%达到pCR。FDG-PET/CT上从阳性变为阴性的结果与pCR之间存在显著关系。
NACRT后行日式扩大三野淋巴结清扫术的经胸段食管切除术是一种安全且有效的治疗方法。
