胸段食管癌颈部淋巴结转移模式的临床意义
Clinical implications of cervical lymph node metastasis patterns in thoracic esophageal cancer.
作者信息
Nishimaki T, Tanaka O, Suzuki T, Aizawa K, Hatakeyama K, Muto T
机构信息
First Department of Surgery, Niigata University School of Medicine, Japan.
出版信息
Ann Surg. 1994 Dec;220(6):775-81. doi: 10.1097/00000658-199412000-00011.
OBJECTIVE
The authors attempt to clarify the clinical implications of cervical lymph node metastases from thoracic esophageal cancers.
SUMMARY BACKGROUND DATA
Cervical lymph node metastases from thoracic esophageal cancer have been considered to be incompatible with curative resection. However, recent studies have demonstrated that cure is achievable in patients with such metastases.
METHODS
Patterns of esophageal cancer metastasis to the cervical nodes and long-term results after tumor resection were investigated in 23 patients undergoing bilateral cervical lymphadenectomy for treatment of thoracic esophageal cancer.
RESULTS
The number of positive nodes per patient was significantly greater (p < 0.05) in lower esophageal cancers (median: 15) than in upper or mid esophageal cancers (median: 2.5). Simultaneous metastases to three nodal regions (the neck, mediastinum, and abdomen) were significantly more common (p < 0.001) in lower esophageal tumors (88.9%) than in upper and mid esophageal lesions (7.1%). Although the overall 5-year survival rate was 16.5%, long-term survival was achieved only in patients with upper or mid esophageal cancer.
目的
作者试图阐明胸段食管癌颈部淋巴结转移的临床意义。
总结背景资料
胸段食管癌颈部淋巴结转移一直被认为与根治性切除不相容。然而，最近的研究表明，有此类转移的患者也可实现治愈。
方法
对23例行双侧颈部淋巴结清扫术治疗胸段食管癌的患者，研究食管癌转移至颈部淋巴结的模式及肿瘤切除后的长期结果。
结果
下胸段食管癌患者每例阳性淋巴结数量（中位数：15个）显著多于上胸段或中胸段食管癌患者（中位数：2.5个）（p<0.05）。下胸段食管癌（88.9%）同时转移至三个淋巴结区域（颈部、纵隔和腹部）的情况显著多于上胸段和中胸段食管癌病变（7.1%）（p<0.001）。尽管总体5年生存率为16.5%，但只有上胸段或中胸段食管癌患者实现了长期生存。
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