综合治疗食管多原发癌22例  

Multidisciplinary therapy for multi-focal esophageal cancer

作　　者：马少华[1] 杨合利 梁震[1] 熊宏超[1] 秦斌[1] 陈克能[1] 

机构地区：[1]北京大学临床肿瘤学院北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室北京肿瘤医院胸外一科,100142

出　　处：《中华胃肠外科杂志》2011年第9期702-704,共3页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（30572130）;北京市卫生系统高层次卫生技术人才培养计划（2009-2-17）;北京市自然科学基金（7102029）;首都发展基金（2005-2020）志谢感谢申潞艳、康晓征、闫万璞、戴亮、杨永波、付浩、黄川、杨永强、王雯、李慧、王菲、杨峰等医师在病例资料收集和建立数据库工作中付出的辛勤劳动

摘　　要：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2011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．Objective To explore the management strategies and outcome of treatment for muhi-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.

关 键 词：食管肿瘤 多原发 外科手术 综合治疗 治疗效果 

分 类 号：R735.1[医药卫生—肿瘤]