Kumegawa H, Tanaka T, Mori S, Kanazawa M, Morinaga K
Dept. of Surgery, Kurume University School of Medicine, Japan.
Gan To Kagaku Ryoho. 1996 Mar;23(4):487-90.
A 61-year-old male consulted our hospital with complaints of pain in swallowing. The X-ray Barium studies and upper gastrointestinal (UGI) scope revealed an irregular ulcerated lesion in the middle portion of the esophagus. He was diagnosed as having small cell carcinoma of the esophagus by means of biopsy specimens. Three courses of combined chemotherapy with CDDP, etoposide and 5-FU were used before operation. Following the chemotherapy, according to the UGI scope findings, the tumor of the esophagus disappeared. An esophagectomy through a thoracolaparotomy was performed. The chemotherapy resulted in a Grade 2 response, as ascertained by means of pathological findings for the resected specimen. After an additional course of chemotherapy, the patient was discharged from the hospital. Although we performed the curative resection for this patient, extensive recurrences and distant metastasis to the mediastinal lymph nodes and lung were found in less than a year. It is said that this tumor has a poor prognosis, and the one-year survival rate is about 10% following the treatment. It is necessary to combine surgery with effective chemotherapy and irradiation to obtain a good prognosis after resection of small cell carcinoma of the esophagus.
一名61岁男性因吞咽疼痛前来我院就诊。X线钡餐检查和上消化道内镜检查发现食管中段有一个不规则溃疡病变。通过活检标本诊断为食管小细胞癌。术前采用顺铂、依托泊苷和5-氟尿嘧啶联合化疗三个疗程。化疗后,根据上消化道内镜检查结果,食管肿瘤消失。通过胸腹联合切口进行了食管切除术。根据切除标本的病理检查结果,化疗产生了2级反应。再进行一个疗程的化疗后,患者出院。尽管我们对该患者进行了根治性切除,但不到一年就发现了广泛复发以及纵隔淋巴结和肺部的远处转移。据说这种肿瘤预后很差,治疗后一年生存率约为10%。为了在食管小细胞癌切除术后获得良好的预后,有必要将手术与有效的化疗和放疗相结合。