Nürnberger H R, Löffler T, Hausamen T U, Theophil B, Löhlein D
Chirurgische Klinik, Städtischen Kliniken Dortmund.
Chirurg. 1993 Sep;64(9):701-7; discussion 707-8.
In a 4-year period (1988-1991) 122 patients with a squamous cell carcinoma of the esophagus were studied prospectively and analysed. 64 patients of them could be primary resected (primary resectability rate 52%), 36 patients were in general inoperable and 22 patients had an advanced stage of cancer with local inoperability. Due to a preoperative combined radiotherapy and chemotherapy 16 of the 22 patients with local inoperability had a clinical remission of the tumor (73%). 11 patients (50%) showed a histological verified down staging and 3 cases of them a complete remission (no primary tumor was found, no infiltration of the regional lymphnodes and no metastatic disease). Curative resection was possible in 14 of 16 patients with clinical remission (2 patients refused surgical treatment). So the resectability rate now increases from 52 to 63%. We conclude that there was no increased rate of postoperative complications or mortality in the combined radio-/chemotherapy group compared with the primary resected patients.
在1988年至1991年的4年期间,对122例食管鳞状细胞癌患者进行了前瞻性研究和分析。其中64例患者可进行原发灶切除(原发灶可切除率为52%),36例患者总体无法手术,22例患者处于癌症晚期,局部无法手术。由于术前进行了联合放疗和化疗,22例局部无法手术的患者中有16例出现了肿瘤的临床缓解(73%)。11例患者(50%)经组织学证实分期降低,其中3例完全缓解(未发现原发肿瘤,区域淋巴结无浸润,无转移病灶)。16例临床缓解的患者中有14例可行根治性切除(2例患者拒绝手术治疗)。因此,可切除率现在从52%提高到了63%。我们得出结论,与原发灶切除的患者相比,联合放化疗组的术后并发症发生率和死亡率没有增加。