CAJ | 학술논문

目的探讨食管多原发癌的治疗策略及疗效。方法回顾性分析2000年3月至201 1年3月间北京大学临床肿瘤医院胸外科收治的22例食管多原发癌患者的临床病理资料，并与同期、同一手术组收治的471例单发食管癌患者的预后进行比较。结果22例食管多原发癌手术采用剖胸食管切除者18例，经裂孔食管切除者4例;接受术前化疗者8例，术后化疗者15例，其中手术前、后均予化疗者6例。471例单发食管癌患者手术采用剖胸食管切除者423例，经裂孔食管切除者60例；接受术前化疗者148例，术后化疗者267例，其中手术前后均予化疗者101例。22例多原发癌患者3年生存率为41.9％,中位生存期为29.2个月;471例单发食管癌患者的3年生存率为54.7％,中位生存期46.8个月；两组比较差异无统计学意义（P=0.051）。结论食管多原发癌治疗效果较差；广泛的食管切除在此类患者中有重要的意义，同时辅以积极的全身综合治疗。
목적탐토식관다원발암적치료책략급료효。방법회고성분석2000년3월지201 1년3월간북경대학림상종류의원흉외과수치적22례식관다원발암환자적림상병리자료，병여동기、동일수술조수치적471례단발식관암환자적예후진행비교。결과22례식관다원발암수술채용부흉식관절제자18례，경렬공식관절제자4례;접수술전화료자8례，술후화료자15례，기중수술전、후균여화료자6례。471례단발식관암환자수술채용부흉식관절제자423례，경렬공식관절제자60례；접수술전화료자148례，술후화료자267례，기중수술전후균여화료자101례。22례다원발암환자3년생존솔위41.9％,중위생존기위29.2개월;471례단발식관암환자적3년생존솔위54.7％,중위생존기46.8개월；량조비교차이무통계학의의（P=0.051）。결론식관다원발암치료효과교차；엄범적식관절제재차류환자중유중요적의의，동시보이적겁적전신종합치료。
Objective To explore the management strategies and outcome of treatment for multi-focal esophageal carcinoma. Methods Twenty two patients with multi-focal esophageal carcinoma who underwent esophagectomy by a single surgeon team from March 2000 to March 2011 at the Beijing Cancer Hospital were reviewed retrospectively. The clinical and pathological characters were analyzed, and the outcome was compared with that of 471 patients with single esophageal carcinoma who received esophagectomy by the same surgeon team during the same period. Results Eighteen out of 22 patients with multi-focal esophageal cancer underwent esophagectomy via transthoracic approach while 4 patients via transhiatal. Eight patients received neoadjuvant chemotherapy and 15 patients received adjuvant chemotherapy. Four hundred and seventy-one out of 471 patients with single esophageal cancer underwent esophagectomy via transthoracic approach while 60 patients via transhiatal.One hundred and fourty-eight patients received neoadjuvant chemotherapy and 267 patients received adjuvant chemotherapy. The 3-year survival of the 22 patients with multi-focal esophageal carcinoma was 41.9％, and the median survival time was 29.2 months. The 3-year survival of the 471 patients with single esophageal carcinoma was 54.7％, and the median survival time was 46.8 months. There was no significant difference in survival between the two groups(P=0.051 ). Conclusions The prognosis of patients with multi-focal occurrence esophageal carcinoma was poor. Extended esophageal resection may be beneficial to these patients with concurrent systemic chemotherapy.