Yamauchi Yoshikane, Nakajima Jun, Mun Mingyon, Shintani Yasushi, Kuroda Hiroaki, Iwata Takekazu, Endo Makoto, Azuma Yoko, Chida Masayuki, Sakao Yukinori, Yoshino Ichiro, Ikeda Norihiko, Matsuguma Haruhisa, Funai Kazuhito, Hashimoto Hiroshi, Kawamura Masafumi
Department of Surgery, Teikyo University School of Medicine, Tokyo 170-8582, Japan.
Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Cancers (Basel). 2023 Feb 25;15(5):1472. doi: 10.3390/cancers15051472.
To clarify the clinical impact and to identify prognostic predictors of surgical intervention for pulmonary metastasis from esophageal cancer, a registry database analysis was performed. From January 2000 to March 2020, patients who underwent resection of pulmonary metastases from primary esophageal cancer at 18 institutions were registered in a database developed by the Metastatic Lung Tumor Study Group of Japan. An amount of 109 cases were reviewed and examined for the prognostic factors for pulmonary metastasectomy of metastases from esophageal cancer. As a result, five-year overall survival after pulmonary metastasectomy was 34.4% and five-year disease-free survival was 22.1%. The multivariate analysis for overall survival revealed that initial recurrence site, maximum tumor size, and duration from primary tumor treatment to lung surgery were selected as the significant prognostic factors ( = 0.043, = 0.048, and = 0.037, respectively). In addition, from the results of the multivariate analysis for disease free survival, number of lung metastases, initial recurrence site, duration from primary tumor treatment to lung surgery, and preoperative chemotherapy for lung metastasis were selected as the significant prognostic factors ( = 0.037, = 0.008, = 0.010, and = 0.020, respectively). In conclusion, eligible patients with pulmonary metastasis from esophageal cancer selected based on the identified prognostic predictors would be good candidates for pulmonary metastasectomy.
为阐明食管癌肺转移手术干预的临床影响并确定预后预测因素,我们进行了一项注册数据库分析。从2000年1月至2020年3月,在日本转移性肺癌研究组建立的数据库中登记了18家机构中接受原发性食管癌肺转移灶切除的患者。对109例患者进行了回顾性分析,以研究食管癌肺转移灶切除术的预后因素。结果显示,肺转移灶切除术后的五年总生存率为34.4%,五年无病生存率为22.1%。总生存的多因素分析显示,初始复发部位、最大肿瘤大小以及从原发性肿瘤治疗到肺部手术的时间被选为显著的预后因素(分别为P = 0.043、P = 0.048和P = 0.037)。此外,从无病生存的多因素分析结果来看,肺转移灶数量、初始复发部位、从原发性肿瘤治疗到肺部手术的时间以及肺转移的术前化疗被选为显著的预后因素(分别为P = 0.037、P = 0.008、P = 0.010和P = 0.020)。总之,根据所确定的预后预测因素选择的合适的食管癌肺转移患者将是肺转移灶切除术的良好候选者。