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[一例多学科治疗食管癌切除术后淋巴结复发并侵犯气管的病例]

[A Case of Lymph Node Recurrence with Invasion to the Trachea after the Resection of Esophageal Cancer Treated by Multidisciplinary Treatment].

作者信息

Hayashi Yoshinori, Motoori Masaaki, Nakatsuka Rie, Nishizawa Yuujiro, Komatsu Hisateru, Miyazaki Susumu, Tomokuni Akira, Komori Takamichi, Iwase Kazuhiro, Fujitani Kazumasa

机构信息

Dept. of Surgery, Suita Municipal Hospital.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):2485-2487.

Abstract

A 78-year-old man who underwent esophagectomy for middle thoracic esophageal squamous cell carcinoma(pT1bN0M0, pStage Ⅰ)was diagnosed with lymph node recurrence 12 months after the initial surgery. He received chemoradiotherapy(5- fluorouracil plus cisplatin); however, the treatment was terminated at the middle of the treatment course because of progressive disease. He received chemotherapy(docetaxel plus 5-fluorouracil plus cisplatin)as a second-line treatment, which was also canceled due to serious adverse events. Partial response was achieved after the second therapy; therefore, surgical excision was performed. Thirteen months after the second surgery, he was diagnosed with second local recurrence with invasion to the trachea. Another course of chemotherapy(docetaxel[2-weekly]plus 5-fluorouracil plus cisplatin)was administered, which also achieved a partial response. Thus, surgical excision with partial tracheal resection and mediastinal tracheostomy was performed. He has been alive without recurrence for 6 months after the final operation. In case of postoperative solitary lymph node recurrence of esophageal cancer, long-term survival can be expected with multidisciplinary treatment.

摘要

一名78岁男性因胸段中段食管鳞状细胞癌(pT1bN0M0,pⅠ期)接受了食管切除术,术后12个月被诊断为淋巴结复发。他接受了放化疗(5-氟尿嘧啶加顺铂);然而,由于疾病进展,治疗在疗程中途终止。他接受了多西他赛加5-氟尿嘧啶加顺铂的二线化疗,但也因严重不良事件而取消。第二次治疗后达到部分缓解;因此,进行了手术切除。第二次手术后13个月,他被诊断为局部再次复发并侵犯气管。又进行了一个疗程的化疗(每2周一次多西他赛加5-氟尿嘧啶加顺铂),也取得了部分缓解。于是,进行了部分气管切除和纵隔气管造口术的手术切除。最后一次手术后,他已存活6个月且无复发。对于食管癌术后孤立性淋巴结复发的情况,多学科治疗有望实现长期生存。

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