Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
Crit Rev Oncol Hematol. 2018 Apr;124:61-65. doi: 10.1016/j.critrevonc.2018.02.011. Epub 2018 Mar 2.
Radical esophagectomy with extended lymph node dissection is considered the standard of care in treatment of squamous cell carcinoma of esophagus with deep mucosal invasion (pT1a m3) or submucosal involvement (pT1b). However, despite the increasing use of minimally invasive approaches, it remains a major surgery associated with significant morbidities and even mortality risk. Endoscopic resection (ER) results in excellent local control in early superficial mucosal (pT1a) disease yet there is substantial risk of lymph node metastases in T1b disease. Therefore, ER followed by combined with chemo-radiotherapy (CRT) would potentially improve the outcome in pT1a m3 or pT1b disease and would be an attractive conservative alternative to esophagectomy. Retrospective series published so far have shown promising results for this combined treatment. Herein the current literature of the indications, treatment outcome and toxicities of this treatment strategy are discussed and critically reviewed.
根治性食管切除术伴扩大淋巴结清扫术被认为是治疗深度黏膜侵犯（pT1a m3）或黏膜下侵犯（pT1b）的食管鳞状细胞癌的标准治疗方法。然而，尽管微创方法的应用日益增多，但它仍然是一种主要的手术，与显著的发病率甚至死亡风险相关。内镜下切除（ER）在早期浅表黏膜（pT1a）疾病中可获得极好的局部控制，但 T1b 疾病存在淋巴结转移的实质性风险。因此，ER 后联合化疗放疗（CRT）可能会改善 pT1a m3 或 pT1b 疾病的预后，并且是一种有吸引力的食管切除术保守替代方法。迄今为止发表的回顾性系列研究显示了这种联合治疗的有希望的结果。本文讨论并批判性地回顾了这种治疗策略的适应证、治疗结果和毒性的现有文献。
