食管鳞状细胞癌和腺癌三野淋巴结清扫术后十年生存和复发模式

Ten-year Survival and Recurrence Patterns after Three-field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the Esophagus.

 (Ann Surg, IF: 13.787)

Altorki Nasser,Mynard Nathan,Nasar Abu et al. Ten-year Survival and Recurrence Patterns after Three-field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the Esophagus.[J] .Ann Surg, 2022, undefined: undefined.

OBJECTIVE 目的

To determine the prevalence of metastases to the cervical and recurrent laryngeal cervicothoracic (CT) nodes as well as survival and recurrence patterns after esophagectomy with three-field lymph node dissection (TFD) in patients with predominately adenocarcinoma (AC) of the esophagus.

探讨食管腺癌(AC)为主的患者行三野淋巴结清扫术(TFD)后，颈部和喉颈胸(CT)淋巴结转移的发生率以及生存和复发模式。

SUMMARY OF BACKGROUND DATA 背景资料

Although esophagectomy with TFD is commonly practiced in Japan and Southeast Asia for squamous cell cancer of the esophagus (SCC), there are only a handful of reports about its' utilization and survival benefit in North American patients.

虽然在日本和东南亚，食管切除术联合TFD治疗食管鳞状细胞癌(SCC)是普遍的做法，但关于其在北美患者中的应用和生存获益的报道很少。

METHODS 方法

This is a retrospective case series of patients who had an esophagectomy with TFD. The primary outcomes of interest were the prevalence of nodal metastases to the CT nodes as well as overall (OS) and disease-free survival (DFS). Secondary outcomes included time to recurrence, recurrence patterns, operative morbidity as well as 30 and 90-day mortality.

这是一个回顾性的病例报道系列，包括接受过食管切除术联合TFD的患者。研究的主要结果是CT淋巴结转移的发生率以及总生存期(OS)和无病生存期(DFS)。次要结果包括复发时间、复发模式、手术发病率以及30天和90天死亡率。

RESULTS 结果

242 patients with esophageal cancer (AC:67%) underwent esophagectomy with TFD. Metastases to the CT nodes were present in 56 patients (23%: AC 20% and SCC 30%). Positive CT nodes were present in 14% of pT1/T2 tumors and 30% of pT3 tumors. For the 56 patients with CT positive nodes, 5-year OS was 25% (AC:16%; SCC:39%). Fifteen of 56 (26.7%) patients with metastases to the CT nodes were alive and disease-free at a minimum of five years postoperatively. Ten-year OS was 43% for all patients with SCC and 28% for patients with AC.

242例食管癌患者(AC:67%)行食管切除术联合TFD。56例患者CT淋巴结转移(23%，AC 20%，SCC 30%)。14%的pT1/T2肿瘤和30%的pT3肿瘤CT淋巴结阳性。56例CT阳性淋巴结患者，5年OS为25% (AC:16%;鳞状细胞癌:39%)。56例CT淋巴结转移的患者中有15例(26.7%)在术后至少5年内存活且无疾病。所有SCC患者的10年OS为43%，AC患者为28%。

CONCLUSIONS 结论

Metastases to the CT nodes are common in both SCC and AC of the esophagus and may be present in at least 14% of early lesions. Five-year survival is encouraging particularly for patients with esophageal SCC cancer.

食管SCC和食管AC病变转移到CT淋巴结是常见的，至少14%的早期病变可能存在转移。5年OS是令人鼓舞的，特别是对于食管SCC患者。