食管梭形细胞癌行食管切除术的预后和预后因素：回顾性单机构分析。
Prognosis and prognostic factors of esophageal spindle cell carcinoma treated by esophagectomy: a retrospective single-institution analysis.
机构信息
Department of Surgery, Keiyukai Sapporo Hospital, Kita1-1, Hondori14-chome, Shiroishi-ku, Sapporo-City, Hokkaido, 003-0027, Japan.
Department of Pathology, Keiyukai Sapporo Hospital, Sapporo, Japan.
出版信息
Esophagus. 2019 Jul;16(3):292-299. doi: 10.1007/s10388-019-00667-y. Epub 2019 Apr 1.
BACKGROUND
Esophageal spindle cell carcinoma (ESpCC) is a malignant tumor composed of sarcomatous components. ESpCC is treated as a squamous cell carcinoma. However, because ESpCC is a rare tumor, little is known regarding its prognosis. This study aimed to analyze patients with ESpCC who were surgically treated at our hospital, determine the validity of surgery, and identify factors that indicate a prognosis.
METHODS
Treatment characteristics, overall survival (OS), and recurrence-free survival (RFS) of 28 patients with ESpCC who underwent surgery at our hospital between 1990 and 2016 were assessed. Furthermore, factors associated with OS and RFS were analyzed.
RESULTS
Subtotal esophagectomy with 3-field lymph node dissection and lower esophagectomy with 2-field lymph node dissection were performed in 25 and 3 patients, respectively. Chemotherapy was administered as preoperative therapy to two patients. Postoperative therapy, comprising radiotherapy and chemotherapy, was administered to three and nine patients, respectively. The 3- and 5-year RFS were 66.4% and 61.6% and the 3- and 5-year OS were 73% and 61.9%, respectively. Macroscopic type was identified as a prognostic factor. In terms of OS, prognosis was significantly worse in ulcerative-type ESpCC than in the polypoid type.
CONCLUSION
The 5-year OS of ESpCC mainly treated with surgical therapy was 61.9%. However, prognosis was poor in some patients with ulcerative-type ESpCC according to macroscopic type. In the future, it will be necessary to accumulate more cases and investigate therapeutic strategies added to surgery to improve prognosis.
背景
食管梭形细胞癌（ESpCC）是一种由肉瘤成分组成的恶性肿瘤。ESpCC 被视为鳞状细胞癌进行治疗。然而，由于 ESpCC 是一种罕见的肿瘤，对于其预后知之甚少。本研究旨在分析在我院接受手术治疗的 ESpCC 患者，确定手术的有效性，并确定预后的相关因素。
方法
评估了 1990 年至 2016 年间在我院接受手术治疗的 28 例 ESpCC 患者的治疗特征、总生存（OS）和无复发生存（RFS）。此外，分析了与 OS 和 RFS 相关的因素。
结果
25 例患者行食管次全切除术联合 3 野淋巴结清扫术，3 例患者行下段食管切除术联合 2 野淋巴结清扫术。有 2 例患者接受了术前化疗。3 例和 9 例患者分别接受了术后放疗和化疗。3 年和 5 年 RFS 分别为 66.4%和 61.6%，3 年和 5 年 OS 分别为 73%和 61.9%。大体类型被认为是预后因素。在 OS 方面，溃疡性 ESpCC 的预后明显差于息肉样型。
结论
主要采用手术治疗的 ESpCC 的 5 年 OS 为 61.9%。然而，根据大体类型，一些溃疡性 ESpCC 患者的预后较差。在未来，有必要积累更多的病例并研究除手术之外的治疗策略，以改善预后。
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