Shimada Ayako, Tsushima Takahiro, Tsubosa Yasuhiro, Booka Eisuke, Takebayashi Katsushi, Niihara Masahiro, Isaka Mitsuhiro, Ohde Yasuhisa, Machida Nozomu, Onozawa Yusuke, Yasui Hirofumi, Takeuchi Hiroya, Kitagawa Yuko
Division of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
World J Surg. 2019 May;43(5):1286-1293. doi: 10.1007/s00268-018-04904-w.
Despite the poor prognosis of recurrent esophageal squamous cell cancer (ESCC), long-term survival could be achieved in a subset of patients who successfully underwent surgical resection for recurrence. In this study, we investigated the outcomes of surgical resection for lymph node (LN) or pulmonary (PUL) recurrence in ESCC patients.
We retrospectively analyzed the outcomes of ESCC patients who underwent surgical resection between January 2008 and March 2015 for either LN or PUL recurrence after complete response (CR) by chemoradiotherapy or R0 esophagectomy. Every patient fulfilled the original institutional criteria: no recurrence at primary site; recurrence involving in only one organ; expectation of complete resection; and for PUL recurrence, no rapid growth with at least 2 months of observation.
Among the 13 patients analyzed, surgical resection was performed in nine and four patients with LN and PUL recurrence, respectively. R0 resection was achieved in all patients with no fatal surgical complications. Mean duration from the day of the first CR/R0 to the recurrence was 809 (110-2575) days. Median recurrence-free survival following surgical resection for recurrence and overall survival following the first diagnosis of recurrence was 387 and 1297 days, respectively.
Surgical resection for LN or PUL recurrence of ESCC according to our institutional criteria can be performed safely for selected patients.
尽管复发性食管鳞状细胞癌（ESCC）预后较差，但部分成功接受复发手术切除的患者可实现长期生存。在本研究中，我们调查了ESCC患者淋巴结（LN）或肺部（PUL）复发的手术切除结果。
我们回顾性分析了2008年1月至2015年3月期间因放化疗完全缓解（CR）或R0食管切除术后LN或PUL复发而接受手术切除的ESCC患者的结果。每位患者均符合原机构标准：原发部位无复发；仅一个器官复发；预期能完全切除；对于PUL复发，观察至少2个月无快速生长。
在分析的13例患者中，分别有9例和4例LN和PUL复发患者接受了手术切除。所有患者均实现R0切除，无致命手术并发症。从首次CR/R0到复发的平均时间为809（110 - 2575）天。复发手术切除后的无复发生存期和首次诊断复发后的总生存期的中位数分别为387天和1297天。
根据我们机构的标准，对选定的ESCC患者进行LN或PUL复发的手术切除可以安全进行。
