Appelqvist P, Mattila S, Jyrälä A, Tala P
Scand J Thorac Cardiovasc Surg. 1977;11(3):278-82.
A clinical series of 216 patients with carcinoma of the oesophagus or cardia, who underwent surgical resection of the oesophagus, is presented. There were 104 patients with oesophageal carcinoma and 112 patients with carcinoma of the cardia. Histologically, there were 102 squamous cell carcinomas, 98 adenocarcinomas, 11 anaplastic carcinomas and 7 non-differentiated carcinomas. Oesophago-gastrotomy was the procedure mostly used; colon interposition was done in only 13 cases. The hospital mortality was 21%. The 5-year survival rate for the whole series after oesophageal resection was 23%. The duration of symptoms, location of the tumour, age and sex of the patients, pre- or postoperative radiotherapy and the histological type of the tumour had only a minor bearing on survival. The two most important prognostic factors were the spread of the tumour at time of operation and a preceding lye stricture. The 5-year survival rate was 34% for the patients with a local tumour at operation and 44% for those in whom the carcinoma developed at the site of a previous lye stricture. The variance of the results in the literature is discussed. Surgical approach to the carcinoma of the oesophagus and cardia is recommended in all the cases in which the patient and tumour seem to be eligible for resection.
本文报告了一组216例行食管手术切除的食管癌或贲门癌患者的临床资料。其中食管癌患者104例，贲门癌患者112例。组织学类型包括102例鳞状细胞癌、98例腺癌、11例间变性癌和7例未分化癌。食管胃吻合术是最常用的术式；仅13例行结肠代食管术。医院死亡率为21%。食管切除术后全组患者的5年生存率为23%。症状持续时间、肿瘤部位、患者年龄和性别、术前或术后放疗以及肿瘤组织学类型对生存率影响较小。两个最重要的预后因素是手术时肿瘤的扩散情况和既往碱液灼伤性狭窄。手术时肿瘤局限的患者5年生存率为34%，癌肿发生于既往碱液灼伤性狭窄部位的患者5年生存率为44%。文中讨论了文献报道结果的差异。对于患者和肿瘤似乎适合切除的所有病例，建议采用手术方法治疗食管癌和贲门癌。
