CAJ | 학술논문

目的探讨以胸外科为主的多学科综合治疗对颈段食管癌的远期疗效.方法回顾性分析北京大学肿瘤医院胸外科单一手术组2000年3月至2011年3月间施行以胸外科保留咽、喉手术为主的多学科综合治疗的41例颈段食管癌患者的临床及随访资料,并与同期同一手术组治疗的480例非颈段食管癌进行比较.结果 41例颈段食管癌患者中男28例,女13例,平均年龄62岁.接受术前化疗30例,术后化疗25例,手术前后均予以化疗21例,术后放疗6例.除4例仅行探查手术外,另37例行食管癌根治性切除颈部吻合,其中1例围手术期死亡.接受根治性切除术并顺利出院的36颈段食管癌患者术后1、3、5和8年累计生存率分别为96.8％、52.6％、35.1％和35.1％;而同期接受根治性切除术并顺利出院的457例非颈段食管癌患者的1年、3年、5年和8年累计生存率分别为85.0％、54.3％、45.0％和36.7％；两组差异无统计学意义(P＞0.05).结论以胸外科为主的多学科综合治疗颈段食管癌能够获得较为满意的远期疗效.
목적 탐토이흉외과위주적다학과종합치료대경단식관암적원기료효.방법 회고성분석북경대학종류의원흉외과단일수술조2000년3월지2011년3월간시행이흉외과보류인、후수술위주적다학과종합치료적41례경단식관암환자적림상급수방자료,병여동기동일수술조치료적480례비경단식관암진행비교.결과 41례경단식관암환자중남28례,녀13례,평균년령62세.접수술전화료30례,술후화료25례,수술전후균여이화료21례,술후방료6례.제4례부행탐사수술외,령37례행식관암근치성절제경부문합,기중1례위수술기사망.접수근치성절제술병순리출원적36경단식관암환자술후1、3、5화8년루계생존솔분별위96.8％、52.6％、35.1％화35.1％;이동기접수근치성절제술병순리출원적457례비경단식관암환자적1년、3년、5년화8년루계생존솔분별위85.0％、54.3％、45.0％화36.7％；량조차이무통계학의의(P＞0.05).결론 이흉외과위주적다학과종합치료경단식관암능구획득교위만의적원기료효.
Objective To evaluate the long-term survival of multidisciplinary treatment based on thoracic surgery for cervical esophageal squamous cell carcinoma.Methods The clinical characters and follow-up data of forty-one cervical esophageal cancer patients who accepted muhidisciplinary treatment based on surgery with preservation of pharynx and larynx were retrospectively reviewed,and the long-term survival was compared with 480 non-cervical esophageal cancers who accepted surgery in the same period done by the same surgical team.Results There were 28 males and 13 females with a mean age of 62 years old.In the cervical esophageal cancer group,30 patients accepted neoadjuvant chemotherapy, 25 patients accepted adjuvant chemotherapy, and 21 patients accepted both. Six patients received postoperative radiation.Four patients underwent exploratory surgery alone,and 37 cases underwent radical surgery and cervical anastomosis.One case died during the perioperative period.The 1-,3-,5- and 8-year survival rates were 96.8％,52.6％,35.1％,and 35.1％ in the 36 patients with cervical esophageal cancer who underwent radical surgery,and were 85.0％,54.3％,45.0％,and 36.7％ respectively in the 457 non-cervical esophageal cancer patients.There was no significant difference between the cervical group and non-cervical group (P=0.91). Conclusion Cervical esophageal cancer should be treated in a multidisciplinary approach to obtain satisfactory longterm outcomes.