食管癌微创术后治疗失败模式及辅助治疗价值评估  

Patterns of Failure After Minimally Invasive Esophagectomy and Evaluation of Value of Adjuvant Therapy for Esophageal Cancer

作　　者：程如田 梁健[2] 韩春[1] 王琪 陈晓希 刘树堂[1] 王澜[1] CHENG Rutian;LIANG Jian;HAN Chun;WANG Qi;CHEN Xiaoxi;LIU Shutang;WANG Lan(Department of Radiation Oncology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Medical Department,Hebei Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北医科大学第四医院放疗科,石家庄050011 [2]河北省胸科医院医务科,石家庄050041

出　　处：《肿瘤防治研究》2023年第9期895-901,共7页Cancer Research on Prevention and Treatment

基　　金：河北省适用医学跟踪项目(GZ2021036);河北省卫生健康委科研基金项目(重点科技研究计划)(20210249)。

摘　　要：我国当前对食管癌术后放疗的推荐主要基于左胸径路不完全两野清扫研究数据,而食管癌外科正处于术式变革期,已逐步由左开胸向右开胸过渡,由开放手术向微创手术(MIE)过渡。当前外科MIE选择适应证人群仍以偏早期患者为主,相较于开放手术,MIE具有更低的创伤性,同时右胸入路也利于更彻底清扫淋巴结,但目前关于食管癌MIE后肿瘤治疗失败模式数据及相关研究较少,很难指导后续治疗,MIE后对于选择性高危患者是否仍需辅助治疗及优选治疗模式仍有待临床探索。基于此背景,本文拟对MIE的安全性及患者长期生存结果、术后复发模式及失败率等问题进行综述,从而探讨术后辅助治疗价值并指导临床治疗。The current recommendation for postoperative radiotherapy for esophageal cancer in China is mainly based on the data of incomplete two-field dissection of open left thoracotomy.At present,the type of surgery for esophageal cancer gradually transitions from open left thoracotomy to open right thoracotomy and from open esophagectomy to minimally invasive esophagectomy(MIE).Patients with early-stage esophageal cancer are selected as candidates for MIE.MIE is less invasive than open esophagectomy,and the right thoracic approach is conducive to more thorough lymph node dissection.However,few data and related studies are available on the patterns of failure after MIE in esophageal cancer,and guiding an adjuvant therapy is difficult.The feasibility of an adjuvant therapy for selective high-risk patients and the optimized treatment after MIE remains to be explored in clinical practice.In this regard,this article aims to review the safety of MIE,long-term survival outcomes,postoperative recurrence patterns,and recurrence rates of patients to discuss the value of postoperative adjuvant therapy and guide clinical treatment.

关 键 词：食管癌 微创食管切除术 失败模式 术后放疗 

分 类 号：R735.1[医药卫生—肿瘤]