Verreet P R, Horstmann O, Röher H D
Klinik für Allgemeine und Unfallchirurgie, Heinrich-Heine-UniversitätDüsseldorf.
Praxis (Bern 1994). 1996 Mar 5;85(10):299-302.
Extensive long segment resection for carcinoma of the esophagus including also consequent mediastinal and celiac lymph node dissection is able to achieve satisfactory radicality only in early tumor stages while there is little influence on long term prognosis for advanced tumor stages. Only better risk analyses and improved surgical outcome with reduced operative mortality has improved the overall outcome. In locally limited primary tumors and even more in locally advanced stages generalisation or dissemination of tumor disease is to be expected. Therefore it is generally agreed upon that only multimodal therapy including systemic chemotherapy and local radiotherapy is able to improve therapeutic results in this disease with otherwise very poor prognosis. We report our own experience on 200 esophageal resections including modification of our strategy and protocol presently in use for tumor stages IIB to IV.
广泛的长节段食管切除术，包括随之进行的纵隔和腹腔淋巴结清扫术，仅在肿瘤早期阶段能够实现令人满意的根治性，而对晚期肿瘤阶段的长期预后影响甚微。只有更好的风险分析和改善手术结果并降低手术死亡率，才能改善总体疗效。在局部局限的原发性肿瘤中，尤其是在局部晚期阶段，预计肿瘤疾病会发生扩散。因此，人们普遍认为，只有包括全身化疗和局部放疗在内的多模式治疗，才能改善这种预后极差疾病的治疗效果。我们报告了我们在200例食管切除术方面的经验，包括对我们目前用于IIB至IV期肿瘤的策略和方案的修改。
