食管鳞状细胞癌非根治性内镜切除术后追加放化疗的长期疗效。

IF 2.6 3区 医学
Hourin Cho, Seiichiro Abe, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Kae Okuma, Shun Yamamoto, Hiroyuki Daiko, Ken Kato, Shigeki Sekine, Narikazu Boku, Yutaka Saito
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引用次数: 0

摘要

食管鳞状细胞癌(ESCC)的内镜下切除术(ER)需要进行病理评估,对于非根治性切除的病例建议进行额外治疗,非根治性切除的定义为伴有淋巴管侵犯(LVI)的pMM、pSM或垂直边缘阳性。本研究旨在评估ESCC患者接受非根治性ER治疗后追加化放疗(CRT)的长期疗效和复发风险因素。我们回顾性地回顾了2007年8月至2017年12月期间接受非根治性ER后附加CRT治疗的ESCC患者的临床病程。分析了复发率和复发的风险因素。在97名非根治性ER患者中,73人接受了额外的CRT治疗。中位随访期为71个月,73名患者中有10人(14%)复发,中位间隔为24.5个月(1-59个月)。3年和5年无复发生存率分别为89%和85%,3年和5年总生存率分别为96%和91%。多变量分析显示,淋巴侵犯是接受额外CRT治疗的非治愈性ESCC患者复发的独立风险因素。在10名复发患者中,分别有4人、3人、2人和1人接受了手术、化疗、支持治疗和CRT治疗。值得注意的是,无论有无区域和/或远处淋巴结转移,接受手术的四名患者全部存活。淋巴侵犯是非治愈性 ESCC 复发的独立风险因素。ER术后至少需要进行5年的仔细随访,并进行额外的CRT治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term outcomes after non-curative endoscopic resection for esophageal squamous cell carcinoma followed by additional chemoradiotherapy.

Endoscopic resection (ER) of esophageal squamous cell carcinoma (ESCC) is evaluated pathologically, and additional treatment is recommended for cases resulting in non-curative resection, defined as pMM with lymphovascular invasion (LVI), pSM, or positive vertical margin. This study aimed to assess long-term outcomes and risk factors for recurrence in patients with ESCC treated with non-curative ER followed by additional chemoradiotherapy (CRT). We retrospectively reviewed the clinical courses of patients who underwent non-curative ER followed by additional CRT for ESCCs between August 2007 and December 2017. Recurrence rates and risk factors for recurrence were analyzed. Among 97 patients with non-curative ER, 73 underwent additional CRT. With a median follow-up period of 71 months, recurrences were observed in 10 (14%) of 73 patients, with a median interval of 24.5 (1-59 months). The 3- and 5-year recurrence-free survival were 89 and 85%, respectively, and the 3- and 5-year overall survival rates were 96 and 91%, respectively. Multivariate analysis showed that lymphatic invasion was an independent risk factor for recurrence in patients with non-curative ESCC receiving additional CRT. Among the 10 patients with recurrence, 4, 3, 2, and 1 underwent surgery, chemotherapy, supportive care, and CRT, respectively. Notably, all four patients who underwent surgery survived, regardless of regional and/or distant lymph node metastasis. Lymphatic invasion is an independent risk factor for the recurrence of non-curative ESCCs. Careful follow-up is required for at least 5 years after ER with additional CRT.

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来源期刊
Diseases of the Esophagus
Diseases of the Esophagus Medicine-Gastroenterology
自引率
7.70%
发文量
568
期刊介绍: Diseases of the Esophagus covers all aspects of the esophagus - etiology, investigation and diagnosis, and both medical and surgical treatment.
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